Abstract
Pleural Mesothelioma (PM) is an aggressive cancer that attacks thousands of people every year. One of the common treatments is surgery to remove the tumor. Unfortunately, around 11% of patients die from blood clots post-surgery. Current predictive factors such as C-reactive protein, D-Dimer, and abnormal platelet count lack specificity. To date, no blood-based protein biomarkers have been identified to reliably predict PM patients at risk of developing Venous Thromboembolism (VTE) post-surgery. In this study, we present a set of host-response plasma protein candidate biomarkers that could predict patients at risk of developing VTE. We employed a quantitative mass spectrometry-based proteomics approach integrated with a multilayered, structured, and systematic evaluation of candidate biomarkers in a cohort of 18 patients, comprising six mesothelioma cases, six mesothelioma controls, and six lung cancer controls. This is the first step towards personalized treatment plans for PM patients undergoing surgery. This study’s findings can potentially guide subsequent, larger-scale investigations, highlighting the value of small-scale exploratory research. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1038/s41598-026-39805-9.