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Soluble Mesothelin-Related Peptides

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Also known as: SMRP
Formal name: Soluble Mesothelin-Related Peptides
Related tests: Tumor Markers

At a Glance

Why Get Tested?

To monitor progression or recurrence of a rare cancer called mesothelioma that affects the membranes that surround the lungs, heart, and abdominal cavity; most cases of mesothelioma are associated with asbestos exposure.

When to Get Tested?

After you have been diagnosed with mesothelioma, this test may be ordered anytime during or after treatment to follow response to treatment.

Sample Required?

A blood sample drawn from a vein in your arm

Test Preparation Needed?


The Test Sample

What is being tested?

Soluble mesothelin-related peptides (SMRP) are breakdown products from proteins found in the membranes that line the cavities surrounding the lungs, heart, and abdomen. High amounts of SMRP are often seen in the blood of people suffering from mesothelioma, and the amount of SMRP in the blood is thought to be related to the extent of disease. This test measures the amount of SMRP in the blood. 

Malignant mesothelioma is a rare cancer of the membranes that cover the outside of internal organs and line body cavities, including the chest (pleural mesothelioma), abdominal cavity (peritoneal mesothelioma), and the heart (pericardial mesothelioma). Between 2,000 and 3,000 new cases are diagnosed annually in the U.S., and pleural mesothelioma is the most common type, accounting for 90% of all cases. Most cases of pleural mesothelioma—about 70% to 80%—arise in people with a history of working with asbestos, especially in the shipbuilding, construction, automotive, and fireproofing industries. The disease has a long latency period, meaning that people usually develop mesothelioma 20 to 50 years after asbestos exposure.

How is the sample collected for testing?

A blood sample is taken by needle from a vein in the arm.

NOTE: If undergoing medical tests makes you or someone you care for anxious, embarrassed, or even difficult to manage, you might consider reading one or more of the following articles: Coping with Test Pain, Discomfort, and Anxiety, Tips on Blood Testing, Tips to Help Children through Their Medical Tests, and Tips to Help the Elderly through Their Medical Tests.

Another article, Follow That Sample, provides a glimpse at the collection and processing of a blood sample and throat culture.

Is any test preparation needed to ensure the quality of the sample?

No test preparation is needed.

The Test

Common Questions

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Article Sources

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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.

Sources Used in Current Review

(Revised 2011 June 16). How is malignant mesothelioma diagnosed? American Cancer Society [On-line information]. Available online at through Accessed November 2011.

(2009 March). Soluble Mesothelin-Related Peptides (MESOMARK®) for Monitoring Patients Diagnosed with Biphasic or Epithellioid Mesothelioma ARUP Technical Bulletins [On-line information]. Available online through Accessed November 2011.

Tan, W. (Updated 2010 October 7). Mesothelioma. Medscape Reference [On-line information]. Available online at through Accessed November 2011.

Wheatley-Price, P. (2010 July 10). Soluble Mesothelin-Related Peptide and Osteopontin As Markers of Response in Malignant Mesothelioma. JCO v(28) 20 [On-line information]. Available online at through Accessed November 2011.

Ray, M. and Kindler, H. (2009 September). Malignant Pleural Mesothelioma, An Update on Biomarkers and Treatment. CHEST v 136 (3) [On-line information]. Available online at through Accessed November 2011.

Sources Used in Previous Reviews

ARUP Laboratories. Soluble Mesothelin-Related Peptides (MESOMARK®). (March 2007, Issued). PDF available for download through Accessed on June 17, 2008.

U.S. Food and Drug Administration, Center for Devices and Radiological Health (February 22, 2007, Updated). New Humanitarian Device Approval: Mesomark ™ - H060004. Available online at through Accessed on June 16, 2008.

Email interview with David Grenache, Medical Director, Special Chemistry, ARUP Laboratories, Salt Lake City, Utah. June 20, 2008.

Pacific Heart & Blood Institute. Mesomark. Available online at through Accessed June 17, 2008.

ARUP Laboratories. The Physician's Guide to Laboratory Test Selection and Interpretation: Mesothelioma. Available online at through Accessed June 17, 2008.

Fujirebio Diagnostics. FAQ: The Mesomark Assay. Available at through Accessed June 18, 2008.

Beyer, H. et al.  Mesomark ™: A Potential Test for Malignant Pleural Mesothelioma. Clinical Chemistry 2007: 53: 666-672.

Creaney, J. et al. Soluble mesothelin in effusions: a useful tool for the diagnosis of malignant mesothelioma. Thorax 2007; 62: 569-576.

U.S. Food and Drug Administration. Center for Devices and Radiological Health Guidance for Industry and FDA Staff: Humanitarian Device Exemption (HDE) Regulation: Questions and Answers. (July 18, 2006, Issued). PDF available for download at through Accessed June 16, 2008.

Fujirebio Diagnostics. Healthcare Professionals: Mesomark ® Approved for Humanitarian Use in the U.S. Available online at through Accessed June 18, 2008.

Cancer Research UK. Mesothelioma Risks and Causes. (February 5, 2008, Updated). Available online at through Accessed June 20, 2008.

National Cancer Institute. Mesothelioma: Questions and Answers. (May 13, 2002, Reviewed). Available online at through Accessed June 20, 2008.