MESOMARK, the first serum-based mesothelin biomarker, continues to be relevant for mesothelioma.1,2 Mesothelioma is easiest to treat and has the best outcomes when it is found early and monitored routinely.3

MESOMARK is an enzyme-linked immunosorbent assay for the quantitative measurement of soluble mesothelin-related peptides (SMRP). SMRP is a cell-surface biomarker that is released into the bloodstream from mesothelioma cells and can be elevated years before an actual diagnosis of mesothelioma is made. By measuring the amount of SMRP present in the bloodstream, the MESOMARK assay may assist with monitoring individuals diagnosed with biphasic or epithelioid mesothelioma for progression or recurrence.4 ARUP is the only laboratory in the U.S. to offer the MESOMARK assay.

Test Code Test Name
0081284 Soluble Mesothelin Related Peptides (MESOMARK®)

What are the benefits of MESOMARK serum SMRP testing?

  • MESOMARK is a blood-based biomarker for monitoring patients with mesothelioma.
  • High concentrations of SMRP can make the diagnosis of malignant pleural mesothelioma (MPM) more likely.4
  • MESOMARK may assist in determining how well a patient may respond to treatment.3,5
  • MESOMARK is most useful in monitoring for the recurrence of a tumor after primary chemotherapy6 and for monitoring for cancer progression.


  • Malignant pleural mesothelioma (MPM) is primarily caused by exposure to asbestos.
  • The incidence rate is 3,000 new cases per year in the U.S.6
  • MPM has a latency period of 30 to 50 years between first asbestos exposure and diagnosis.7
  • The clinical symptoms of MPM are usually nonspecific, which can lead to a late diagnosis and poor prognosis.7

How is the MESOMARK test performed?

A blood sample is taken from the patient, then serum is removed and sent to ARUP to determine the concentration of SMRP. SMRP are measured by a sandwich immunoassay that utilizes two SMRP-specific monoclonal antibodies.


What do the MESOMARK test results mean?

Physicians should use the MESOMARK test in conjunction with other diagnostic results to make decisions about the monitoring of their patients. Increasing results may be indicative of progressive disease, decreasing results may be indicative of response to therapy and constant results may be associated with stable disease.


  1. Park EK, et al. Follow-up of soluble mesothelin-related protein levels in participants with asbestos-related disorders. Saf Health Work. 2020;11(4):425–30.
  2. Demir M, et al. Evaluation of new biomarkers in the prediction of malignant mesothelioma in subjects with environmental asbestos exposure. Lung. 2016;194:409–17.
  3. American Cancer Society. Malignant mesothelioma: Early detection, diagnosis, and staging. [Accessed: Oct 2022].
  4. Hollevoet K, et al. Serial measurements of mesothelioma serum biomarkers in asbestos-exposed individuals: a prospective longitudinal cohort study. J Thorac Oncol. 2011;6(5):889–95.
  5. Burt BM, et al. Soluble mesothelin-related peptides to monitor recurrence after resection of pleural mesothelioma. Ann Thorac Surg. 2017;104:1679–87.
  6. Carbone M, et al. Mesothelioma: scientific clues for prevention, diagnosis, and therapy [published correction appears in CA Cancer J Clin. 2020;70(4):313–4]. CA Cancer J Clin. 2019;69(5):402–29.
  7. Schillebeeckx E, et al. Clinical utility of diagnostic biomarkers in malignant pleural mesothelioma: a systematic review and meta-analysis. Eur Respir Rev. 2021;30(162):210057.