View source for BAP1 Gene Mutation in Mesothelioma

{{#seo:
|title=BAP1 Gene Mutation in Mesothelioma: Testing, Risk & Treatment
|title_mode=replace
|description=BAP1 germline mutations raise mesothelioma risk 15–25%, but asbestos remains the legal cause. Learn BAP1 testing, L-BAM, tazemetostat, and family screening.
|keywords=BAP1 mesothelioma, germline BAP1 mutation, BAP1 tumor predisposition syndrome, hereditary mesothelioma, BAP1 IHC testing, L-BAM, tazemetostat mesothelioma, BAP1 genetic testing
|author=Rod De Llano, Founding Partner, Danziger & De Llano
|published_time=2026-05-30
|type=Article
|image=logo.png
|image_alt=WikiMesothelioma — BAP1 Gene Mutation in Mesothelioma
}}

{| class="infobox" style="float:right; width:300px; border:1px solid #dee2e6; border-radius:8px; overflow:hidden; margin:0 0 1em 1em;"
|-
! colspan="2" style="background:#1a5276; color:white; padding:12px; text-align:center; font-size:1.1em;" | BAP1 Gene Mutation in Mesothelioma
|-
! colspan="2" style="background:#1a5276; color:white; padding:8px; text-align:left;" | Quick Facts
|-
| style="padding:8px; font-weight:bold;" | Gene
| style="padding:8px;" | BAP1 (BRCA1-Associated Protein 1)
|-
| style="padding:8px; font-weight:bold;" | Chromosome
| style="padding:8px;" | 3p21.1
|-
| style="padding:8px; font-weight:bold;" | Function
| style="padding:8px;" | Tumor-suppressor deubiquitylase
|-
| style="padding:8px; font-weight:bold;" | Germline carriers in mesothelioma
| style="padding:8px;" | ~3–7% of patients
|-
| style="padding:8px; font-weight:bold;" | Lifetime mesothelioma risk (carriers)
| style="padding:8px;" | ~15–25%
|-
| style="padding:8px; font-weight:bold;" | Somatic BAP1 loss (epithelioid)
| style="padding:8px;" | ~60% of tumors
|-
| style="padding:8px; font-weight:bold;" | Proximate legal cause
| style="padding:8px;" | Asbestos exposure
|-
| style="padding:8px; font-weight:bold;" | Test methods
| style="padding:8px;" | Tumor IHC; germline blood NGS
|-
| style="padding:8px; font-weight:bold;" | Targeted therapy
| style="padding:8px;" | Tazemetostat (EZH2 inhibitor)
|-
| colspan="2" style="background:#1a5276; padding:10px; text-align:center;" | <span data-nosnippet class="noai-content">[https://dandell.com/contact-us/ <span style="color:white; font-weight:bold;">Free Case Review →</span>]</span>
|}

== Executive Summary ==

'''BAP1 (BRCA1-Associated Protein 1)''' is a tumor-suppressor gene whose loss is the single most common molecular event in malignant pleural mesothelioma (MPM). A small but important share of patients — roughly '''3–7%''' — carry an inherited (germline) BAP1 mutation in every cell of the body, a condition called '''BAP1 tumor predisposition syndrome'''.<ref name="testa2011" /> The landmark 2011 discovery that germline BAP1 mutations predispose to mesothelioma established BAP1 as the first inherited gene known to affect mesothelioma risk.<ref name="testa2011" /> Carriers face a markedly elevated lifetime mesothelioma risk of approximately '''15–25%''', alongside heightened risks of uveal melanoma, cutaneous melanoma, and clear cell renal carcinoma.<ref name="carbone2022" />

Crucially for patients and their families, a BAP1 mutation does '''not''' change the legal cause of the disease. Under the long-established "two-hit" model, even a germline carrier requires asbestos exposure to trigger the second genetic hit that initiates a tumor — '''asbestos exposure remains the proximate cause''' of mesothelioma, and a manufacturer cannot escape liability by pointing to a victim's inherited susceptibility.<ref name="carbone2025" /> Courts apply the "eggshell plaintiff" doctrine: a defendant who exposes a genetically susceptible person to asbestos bears full responsibility for the resulting cancer.

BAP1 status also shapes diagnosis and treatment. Loss of BAP1 protein on tissue immunohistochemistry (IHC) is a highly specific marker that helps pathologists distinguish true mesothelioma from benign reactive tissue,<ref name="cigognetti" /> and BAP1 inactivation creates a synthetic-lethal vulnerability exploited by the EZH2 inhibitor tazemetostat.<ref name="zauderer" /> A distinct, less aggressive germline-associated subtype — low-grade BAP1-associated mesothelioma (L-BAM) — has been characterized in carriers and is associated with longer survival than typical sporadic disease.<ref name="carbone2025" />

== At a Glance ==

'''BAP1 gene mutation in mesothelioma at a glance:'''

* '''~3–7% of mesothelioma patients''' carry an inherited (germline) BAP1 mutation present in every cell and transmissible to children.<ref name="testa2011" />
* '''~60% of epithelioid mesothelioma tumors''' show somatic (acquired, tumor-only, non-inherited) loss of BAP1 — a finding that does not put relatives at risk.<ref name="cigognetti" />
* '''15–25% lifetime mesothelioma risk''' for germline BAP1 carriers, versus roughly 1 in 3,000 in the general population.<ref name="carbone2022" />
* '''Asbestos remains the proximate cause''' — germline BAP1 is a susceptibility factor, not an independent sufficient cause of mesothelioma.<ref name="carbone2025" />
* '''BAP1 loss on immunohistochemistry (IHC)''' is a highly specific marker separating malignant mesothelioma from benign reactive mesothelial tissue.<ref name="cigognetti" />
* '''Tazemetostat''', an EZH2 (enhancer of zeste homolog 2) inhibitor, targets BAP1-inactivated mesothelioma through synthetic lethality.<ref name="zauderer" />
* '''L-BAM (low-grade BAP1-associated mesothelioma)''' is a distinct germline-associated subtype with slower growth and better prognosis than sporadic disease.<ref name="carbone2025" />
* '''First-degree relatives''' of confirmed germline carriers should be offered genetic counseling, BAP1 testing, and multi-cancer surveillance.<ref name="carbone2022" />
* '''Immunotherapy''' (nivolumab plus ipilimumab) is a first-line standard for unresectable mesothelioma regardless of BAP1 status.<ref name="checkmate743" />
* '''Documented hereditary BAP1''' can strengthen — not weaken — a family's legal position by clarifying which relatives share both the mutation and a common asbestos-exposure history.

== Key Facts ==

{| class="wikitable" style="width:100%; margin:1em 0; border-collapse:collapse; border:2px solid #1a5276;"
|-
! style="background:#1a5276; color:white; padding:12px; text-align:left; width:38%;" | Measure
! style="background:#1a5276; color:white; padding:12px; text-align:left;" | Finding (Source)
|-
| style="padding:10px; font-weight:bold; border-bottom:1px solid #dee2e6;" | First inherited mesothelioma gene
| style="padding:10px; border-bottom:1px solid #dee2e6;" | '''Germline BAP1''' — first demonstrated to predispose to malignant mesothelioma (Testa et al., ''Nature Genetics'', 2011)<ref name="testa2011" />
|-
| style="padding:10px; font-weight:bold; border-bottom:1px solid #dee2e6;" | Germline carrier frequency
| style="padding:10px; border-bottom:1px solid #dee2e6;" | '''~3–7%''' of all mesothelioma patients (Carbone et al., ''J Thorac Oncol'', 2022)<ref name="carbone2022" />
|-
| style="padding:10px; font-weight:bold; border-bottom:1px solid #dee2e6;" | Somatic BAP1 loss (epithelioid MPM)
| style="padding:10px; border-bottom:1px solid #dee2e6;" | '''~60%''' of epithelioid malignant pleural mesothelioma (MPM) tumors (Cigognetti et al., ''Modern Pathology'', 2015)<ref name="cigognetti" />
|-
| style="padding:10px; font-weight:bold; border-bottom:1px solid #dee2e6;" | Carrier lifetime mesothelioma risk
| style="padding:10px; border-bottom:1px solid #dee2e6;" | '''~15–25%''' (Carbone et al., ''J Thorac Oncol'', 2022)<ref name="carbone2022" />
|-
| style="padding:10px; font-weight:bold; border-bottom:1px solid #dee2e6;" | Diagnostic marker
| style="padding:10px; border-bottom:1px solid #dee2e6;" | '''BAP1 IHC loss''' is highly specific for mesothelioma vs. reactive mesothelium (Cigognetti et al., 2015)<ref name="cigognetti" />
|-
| style="padding:10px; font-weight:bold; border-bottom:1px solid #dee2e6;" | Targeted therapy
| style="padding:10px; border-bottom:1px solid #dee2e6;" | '''Tazemetostat''' (EZH2 inhibitor) in relapsed BAP1-inactivated MPM (Zauderer et al., ''Lancet Oncology'', 2022)<ref name="zauderer" />
|-
| style="padding:10px; font-weight:bold; border-bottom:1px solid #dee2e6;" | Germline-associated subtype
| style="padding:10px; border-bottom:1px solid #dee2e6;" | '''L-BAM''' — distinct, less aggressive phenotype in germline carriers (Carbone et al., ''J Thorac Oncol'', 2025)<ref name="carbone2025" />
|-
| style="padding:10px; font-weight:bold;" | Proximate legal cause
| style="padding:10px;" | '''Asbestos exposure''' — BAP1 is a susceptibility co-factor, not an independent cause (Carbone et al., 2025)<ref name="carbone2025" />
|}

== What Is the BAP1 Gene and What Does It Do? ==

BAP1 (BRCA1-Associated Protein 1) is located on the short arm of chromosome 3 (3p21.1) and encodes a nuclear deubiquitylase — an enzyme that removes ubiquitin tags from target proteins. In healthy cells, BAP1 functions as a tumor suppressor with several jobs: it helps repair DNA damage through the homologous-recombination pathway, regulates chromatin remodeling and gene expression, controls cell-cycle progression, and restrains cancer-cell survival signals.

BAP1 follows the classic two-copy (Knudson) tumor-suppressor logic. Every person carries two copies of the gene, one from each parent. A cell only loses BAP1's protective function when '''both''' copies are inactivated — through mutation, deletion, or epigenetic silencing. When that happens, the cell sheds an important brake on tumor formation. This two-copy requirement is central both to how BAP1-related mesothelioma develops and to why asbestos exposure remains essential to the disease, as explained below.

== Somatic vs. Germline BAP1: What Is the Difference? ==

The distinction between somatic and germline BAP1 mutations is the most important thing for patients and families to understand, because only one of the two has implications for relatives.

{| class="wikitable" style="width:100%; margin:1em 0; border-collapse:collapse; border:2px solid #1a5276;"
|-
! style="background:#1a5276; color:white; padding:12px; text-align:left;" | Type
! style="background:#1a5276; color:white; padding:12px; text-align:left;" | What it means
! style="background:#1a5276; color:white; padding:12px; text-align:left;" | Family risk
|-
| style="padding:10px; font-weight:bold; border-bottom:1px solid #dee2e6;" | Somatic BAP1 loss
| style="padding:10px; border-bottom:1px solid #dee2e6;" | Acquired during life, present only in the tumor cells; not inherited. Seen in ~60% of epithelioid MPM.
| style="padding:10px; border-bottom:1px solid #dee2e6;" | None — relatives are not affected
|-
| style="padding:10px; font-weight:bold;" | Germline BAP1 mutation
| style="padding:10px;" | Inherited; present in every cell including blood; transmissible to children. Seen in ~3–7% of mesothelioma patients.
| style="padding:10px;" | First-degree relatives may carry the same mutation
|}

Most mesothelioma patients with BAP1-deficient tumors have '''somatic''' loss — the mutation arose in the tumor alone and is not passed to children. Only a minority carry a '''germline''' mutation that is present from birth in every cell. The only way to tell the two apart is a germline blood test (see testing section). This is why a BAP1-deficient tumor on biopsy is a '''trigger to consider''' germline testing — not proof of an inherited syndrome by itself.<ref name="cigognetti" />

== Does a BAP1 Mutation Cause Mesothelioma Instead of Asbestos? ==

No. This is a recurring argument raised by asbestos defendants, and it has been consistently rejected by medical experts and courts. A germline BAP1 mutation '''increases susceptibility''' to asbestos-induced mesothelioma; it does not independently cause the disease.<ref name="carbone2025" />

* '''The two-hit requirement.''' A germline carrier is born with only one defective BAP1 copy. A tumor cannot form until the second, normal copy is also knocked out in a mesothelial cell. In mesothelioma, that "second hit" is driven by asbestos fiber exposure. Without asbestos, the second hit would not have occurred at that time and place — meaning the exposure is the necessary, precipitating cause.<ref name="carbone2025" />
* '''Susceptibility is not causation.''' A BAP1 carrier with no asbestos exposure has a far lower mesothelioma risk than a carrier with significant exposure. The mutation loads the dice; asbestos rolls them.<ref name="carbone2022" />
* '''Asbestos is carcinogenic regardless of host genetics.''' The carcinogenicity of asbestos fibers is established independent of BAP1 status. A manufacturer that placed asbestos in a workplace or product cannot avoid responsibility by pointing to a victim's inherited vulnerability.
* '''The eggshell-plaintiff rule.''' Long-settled tort doctrine holds defendants liable for the full harm they cause, even when a plaintiff was unusually vulnerable to injury. A genetically susceptible worker is entitled to the same protection — and the same recovery — as anyone else.
* '''Scientific consensus.''' Expert consensus, reflected in 2025 phenotyping work led by Carbone and colleagues, treats germline BAP1 as a susceptibility factor for which asbestos remains a necessary co-factor — not as a stand-alone explanation for the cancer.<ref name="carbone2025" />

== What Is BAP1 Tumor Predisposition Syndrome? ==

BAP1 tumor predisposition syndrome is the hereditary cancer condition caused by a germline BAP1 mutation. It is considered high-penetrance: most carriers will develop at least one BAP1-associated cancer in their lifetime, and many develop more than one sequentially.<ref name="carbone2022" />

{| class="wikitable" style="width:100%; margin:1em 0; border-collapse:collapse; border:2px solid #1a5276;"
|-
! style="background:#1a5276; color:white; padding:12px; text-align:left;" | Cancer type
! style="background:#1a5276; color:white; padding:12px; text-align:left;" | Lifetime risk in germline carriers
|-
| style="padding:10px; font-weight:bold; border-bottom:1px solid #dee2e6;" | Mesothelioma (all sites)
| style="padding:10px; border-bottom:1px solid #dee2e6;" | ~15–25%<ref name="carbone2022" />
|-
| style="padding:10px; font-weight:bold; border-bottom:1px solid #dee2e6;" | Uveal (eye) melanoma
| style="padding:10px; border-bottom:1px solid #dee2e6;" | Markedly elevated above the general population<ref name="carbone2022" />
|-
| style="padding:10px; font-weight:bold; border-bottom:1px solid #dee2e6;" | Cutaneous (skin) melanoma
| style="padding:10px; border-bottom:1px solid #dee2e6;" | Elevated<ref name="carbone2022" />
|-
| style="padding:10px; font-weight:bold;" | Clear cell renal cell carcinoma
| style="padding:10px;" | Elevated<ref name="carbone2022" />
|}

Because the syndrome spans several organ systems, carriers benefit from coordinated, lifelong surveillance rather than single-organ follow-up. The management framework for carriers and their relatives is discussed in the family section below.

== What Is L-BAM (Low-Grade BAP1-Associated Mesothelioma)? ==

L-BAM — low-grade BAP1-associated mesothelioma — is a distinct subtype characterized in patients with germline BAP1 mutations. Compared with typical sporadic (asbestos-induced) mesothelioma, L-BAM tends to be epithelioid and well-differentiated, grows more slowly, carries fewer co-occurring molecular alterations, and is associated with longer survival.<ref name="carbone2025" />

The clinical implications are significant. L-BAM patients can survive and respond to therapy over much longer horizons than the historical 12–18 month median for sporadic disease. The existence of this subtype is also a reason to test for germline BAP1 in younger patients and those with limited exposure histories — identifying L-BAM changes prognosis discussions and surveillance planning, and it flags relatives who may benefit from screening.<ref name="carbone2025" /> Importantly, the favorable biology of L-BAM does not alter the causal role of asbestos: these tumors still arise in the context of fiber exposure acting on a susceptible host.

== How Is BAP1 Tested in Mesothelioma? ==

Two different tests answer two different questions, and both abbreviations are spelled out on first use.

* '''Tumor immunohistochemistry (IHC).''' Performed on biopsy tissue at diagnosis, BAP1 IHC stains for the presence or absence of BAP1 protein in tumor-cell nuclei. '''Retained''' nuclear staining is normal; '''lost''' staining strongly supports a malignant mesothelioma diagnosis and helps separate it from benign reactive mesothelial proliferations. BAP1 IHC loss is one of the most specific tissue markers available to pathologists.<ref name="cigognetti" />
* '''Germline next-generation sequencing (NGS).''' Performed on a blood sample, germline NGS determines whether a BAP1 mutation is present in every cell — meaning it is inherited and potentially shared by relatives. Results typically take 2–4 weeks, and genetic counseling is recommended before and after testing.<ref name="carbone2022" />

Germline BAP1 testing should be considered for any mesothelioma patient with a BAP1-deficient epithelioid tumor, a personal or family history of uveal melanoma, renal cancer, or additional mesotheliomas, a younger-than-average age at diagnosis, or limited documented asbestos exposure.<ref name="carbone2022" /> Tissue biomarker testing typically also includes a panel of other markers — for example serum mesothelin, a shed protein used as a treatment-monitoring biomarker — that together refine the diagnosis.<ref name="robinson" /> For the broader 2026 testing landscape, see [[Mesothelioma Diagnostic Technology]].

== How Does BAP1 Status Affect Mesothelioma Treatment? ==

BAP1 status increasingly informs therapy selection.

* '''Tazemetostat (EZH2 inhibitor).''' When BAP1 is lost, the cell becomes dependent on the opposing chromatin regulator EZH2 (enhancer of zeste homolog 2). Inhibiting EZH2 in BAP1-deficient cells reverses their abnormal epigenetic program and selectively kills them while sparing BAP1-intact normal cells — a "synthetic lethal" relationship. The oral EZH2 inhibitor tazemetostat was evaluated in relapsed or refractory, BAP1-inactivated malignant pleural mesothelioma and showed clinical activity in this molecularly selected group.<ref name="zauderer" />
* '''Immunotherapy.''' First-line nivolumab plus ipilimumab is an established standard for unresectable mesothelioma and improves overall survival (OS) regardless of BAP1 status.<ref name="checkmate743" />
* '''Metabolic targeting (ASS1 / arginine).''' Many mesotheliomas silence argininosuccinate synthetase 1 (ASS1), making them dependent on external arginine. Arginine-depleting therapy with pegylated arginine deiminase showed activity in ASS1-deficient mesothelioma,<ref name="szlosarek2017" /> and the approach was advanced in the first-line ATOMIC-Meso randomized trial of pegargiminase plus chemotherapy.<ref name="atomic" /> See [[ATOMIC-Meso Trial]] for detail.

These BAP1-informed and biomarker-informed options are part of why modern molecular testing at diagnosis matters: it opens doors to targeted drugs and clinical trials that a BAP1-deficient patient might otherwise miss.

== What Should Families of BAP1 Carriers Do? ==

When a germline BAP1 mutation is confirmed, the focus widens from the patient to the family. First-degree relatives — parents, siblings, and children — each have a meaningful chance of carrying the same mutation and should be offered genetic counseling and germline BAP1 testing.<ref name="carbone2022" />

Confirmed carriers benefit from coordinated, lifelong multi-cancer surveillance:

{| class="wikitable" style="width:100%; margin:1em 0; border-collapse:collapse; border:2px solid #1a5276;"
|-
! style="background:#1a5276; color:white; padding:12px; text-align:left;" | Surveillance
! style="background:#1a5276; color:white; padding:12px; text-align:left;" | Typical interval
! style="background:#1a5276; color:white; padding:12px; text-align:left;" | Clinician
|-
| style="padding:10px; font-weight:bold; border-bottom:1px solid #dee2e6;" | Eye exam (uveal melanoma)
| style="padding:10px; border-bottom:1px solid #dee2e6;" | Annual
| style="padding:10px; border-bottom:1px solid #dee2e6;" | Ocular oncologist
|-
| style="padding:10px; font-weight:bold; border-bottom:1px solid #dee2e6;" | Skin exam (melanoma)
| style="padding:10px; border-bottom:1px solid #dee2e6;" | Annual
| style="padding:10px; border-bottom:1px solid #dee2e6;" | Dermatologist
|-
| style="padding:10px; font-weight:bold; border-bottom:1px solid #dee2e6;" | Renal imaging
| style="padding:10px; border-bottom:1px solid #dee2e6;" | Every 1–2 years
| style="padding:10px; border-bottom:1px solid #dee2e6;" | Urologist / oncologist
|-
| style="padding:10px; font-weight:bold;" | Chest / abdominal imaging
| style="padding:10px;" | Every 1–2 years
| style="padding:10px;" | Oncologist
|}

Early detection has not been proven to reduce mortality in carriers, but it materially improves treatment options — particularly for uveal melanoma, where early treatment can be curative, and for L-BAM mesothelioma, where indolent biology rewards early intervention.<ref name="carbone2022" />

There is also a legal dimension that families should understand. A documented hereditary BAP1 mutation does not weaken a mesothelioma claim — it can clarify it. Relatives who share both the mutation and a common household or occupational asbestos-exposure history (for example, take-home fibers carried on a worker's clothing) may each have a viable claim if they develop disease. Establishing the family's shared exposure sources is exactly the work plaintiff firms do in trust-fund and litigation claims, and a documented hereditary mutation can help clarify which relatives share both the genetic predisposition and a common exposure history. For related guidance, see [[Filing an Asbestos Exposure Claim]].

== Frequently Asked Questions ==

'''Does having a BAP1 mutation mean asbestos did not cause my mesothelioma?'''
No. A germline BAP1 mutation increases susceptibility, but asbestos exposure is still the necessary, precipitating cause under the two-hit model. Courts hold asbestos defendants fully liable even when a plaintiff was genetically vulnerable.<ref name="carbone2025" />

'''Is BAP1 mutation in my tumor inherited?'''
Not necessarily. Most BAP1-deficient tumors carry a somatic (tumor-only, non-inherited) mutation. Only a germline blood test can determine whether the mutation is inherited and shared by relatives.<ref name="cigognetti" />

'''How common are germline BAP1 mutations in mesothelioma?'''
Roughly 3–7% of all mesothelioma patients carry a germline BAP1 mutation.<ref name="testa2011" />

'''What cancers are linked to BAP1 tumor predisposition syndrome?'''
Mesothelioma, uveal melanoma, cutaneous melanoma, and clear cell renal cell carcinoma are the core cancers; carriers warrant multi-organ surveillance.<ref name="carbone2022" />

'''Is there a targeted treatment for BAP1-mutated mesothelioma?'''
The EZH2 inhibitor tazemetostat targets BAP1-inactivated mesothelioma through synthetic lethality and showed activity in relapsed disease. First-line immunotherapy (nivolumab plus ipilimumab) benefits patients regardless of BAP1 status.<ref name="zauderer" /><ref name="checkmate743" />

'''What is L-BAM?'''
L-BAM (low-grade BAP1-associated mesothelioma) is a slower-growing, better-prognosis germline-associated subtype distinct from typical sporadic mesothelioma.<ref name="carbone2025" />

'''Should my children be tested if I have a germline BAP1 mutation?'''
First-degree relatives should be offered genetic counseling and germline BAP1 testing, followed by surveillance if they test positive.<ref name="carbone2022" />

== Quick Statistics ==

* '''~3–7%''' of mesothelioma patients carry a germline BAP1 mutation.<ref name="testa2011" />
* '''~60%''' of epithelioid malignant pleural mesothelioma tumors show somatic BAP1 loss.<ref name="cigognetti" />
* '''15–25%''' lifetime mesothelioma risk for germline BAP1 carriers.<ref name="carbone2022" />
* '''~1 in 3,000''' baseline mesothelioma risk in the general population.<ref name="carbone2022" />
* '''2011''' — year germline BAP1 was first shown to predispose to mesothelioma.<ref name="testa2011" />
* '''Tazemetostat''' — first EZH2 inhibitor studied in BAP1-inactivated mesothelioma.<ref name="zauderer" />
* '''L-BAM''' — germline-associated subtype with longer survival than sporadic disease.<ref name="carbone2025" />
* '''Asbestos''' — the proximate legal cause of mesothelioma in BAP1 carriers and non-carriers alike.<ref name="carbone2025" />

== Related Pages ==

* [[Pleural Mesothelioma]]
* [[Peritoneal Mesothelioma]]
* [[Mesothelioma Prognosis]]
* [[Mesothelioma Diagnostic Technology]]
* [[ATOMIC-Meso Trial]]
* [[Filing an Asbestos Exposure Claim]]

== External Links ==

<span data-nosnippet class="noai-content">
If you or a loved one was diagnosed with mesothelioma and a germline BAP1 mutation has been documented — or raised by a defense expert — compensation pathways exist and are time-sensitive. A genetic susceptibility does not bar recovery.

* '''[https://dandell.com/ Danziger & De Llano]''' — free case evaluations for mesothelioma and asbestos-related disease; every applicable claim type (asbestos bankruptcy trust funds, civil personal injury and wrongful death lawsuits, VA disability claims for veterans) from a single intake. '''Call (855) 699-5441''' or visit [https://dandell.com/contact-us/ dandell.com/contact-us].
* '''[https://www.mesotheliomalawyercenter.org/ Mesothelioma Lawyer Center]''' — patient and family resources on diagnosis, treatment, clinical trials, and legal options.
* '''[https://mesothelioma.net/ Mesothelioma.net]''' — information on mesothelioma diagnostic workup, treatment, genetic testing, and prognosis.

State statutes of limitations begin running at diagnosis, and trust fund claims have separate, shorter deadlines. Speaking with an experienced mesothelioma attorney early preserves every option.
</span>

== References ==
<references>
<ref name="testa2011">Testa JR, Cheung M, Pei J, et al. [https://pubmed.ncbi.nlm.nih.gov/21874000/ Germline BAP1 mutations predispose to malignant mesothelioma]. ''Nature Genetics''. 2011;43(10):1022–1025. PMID 21874000.</ref>
<ref name="carbone2025">Carbone M, Minaai M, Kittaneh M, Krausz T, Miettinen MM, et al. [https://pubmed.ncbi.nlm.nih.gov/40582407/ Clinical and Pathologic Phenotyping of Mesotheliomas Developing in Carriers of Germline BAP1 Mutations]. ''J Thorac Oncol''. 2025. PMID 40582407.</ref>
<ref name="carbone2022">Carbone M, Pass HI, Ak G, Alexander HR, Baas P, et al. [https://pubmed.ncbi.nlm.nih.gov/35462085/ Medical and Surgical Care of Patients With Mesothelioma and Their Relatives Carrying Germline BAP1 Mutations]. ''J Thorac Oncol''. 2022;17(7):873–889. PMID 35462085.</ref>
<ref name="cigognetti">Cigognetti M, Lonardi S, Fisogni S, Balzarini P, Pellegrini V, et al. [https://pubmed.ncbi.nlm.nih.gov/26022455/ BAP1 (BRCA1-associated protein 1) is a highly specific marker for differentiating mesothelioma from reactive mesothelial proliferations]. ''Mod Pathol''. 2015;28(8):1043–1057. PMID 26022455.</ref>
<ref name="zauderer">Zauderer MG, Szlosarek PW, Le Moulec S, Popat S, Taylor P, et al. [https://pubmed.ncbi.nlm.nih.gov/35588752/ EZH2 inhibitor tazemetostat in patients with relapsed or refractory, BAP1-inactivated malignant pleural mesothelioma: a multicentre, open-label, phase 2 study]. ''The Lancet Oncology''. 2022;23(6):758–767. PMID 35588752.</ref>
<ref name="checkmate743">Baas P, Scherpereel A, Nowak AK, Fujimoto N, Peters S, et al. [https://pubmed.ncbi.nlm.nih.gov/33485464/ First-line nivolumab plus ipilimumab in unresectable malignant pleural mesothelioma (CheckMate 743): a multicentre, randomised, open-label, phase 3 trial]. ''The Lancet''. 2021;397(10272):375–386. PMID 33485464.</ref>
<ref name="szlosarek2017">Szlosarek PW, Steele JP, Nolan L, Gilligan D, Taylor P, et al. [https://pubmed.ncbi.nlm.nih.gov/27584578/ Arginine Deprivation With Pegylated Arginine Deiminase in Patients With Argininosuccinate Synthetase 1-Deficient Malignant Pleural Mesothelioma: A Randomized Clinical Trial]. ''JAMA Oncology''. 2017;3(1):58–66. PMID 27584578.</ref>
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</references>

[[Category:Medical]]
[[Category:Mesothelioma]]
[[Category:Genetics]]
[[Category:Biomarkers]]
[[Category:Diagnosis]]
[[Category:Mesothelioma Research]]
[[Category:Hereditary Cancer]]