The Centers for Disease Control and Prevention (CDC) has recently released a report detailing the numbers of deaths and years of productivity lost among people who died before 65 years-old because of asbestosis. The CDC’s report only looked at asbestosis-related deaths, so these numbers do not take into account deaths from any of the forms of malignant mesothelioma, such as pleural mesothelioma or peritoneal mesothelioma, or from asbestos-induced lung cancer. Even without including these other diseases, however, these numbers speak to the devastating effects that decades worth of asbestos use have had on human health.

To create this report, the CDC looked at all examples of asbestosis-related deaths between 1968 and 2005, which totaled 9,024. From within this figure, they identified 1,169 individuals who died between the ages of 25 and 64. 65 years-old is the common cutoff used to differentiate a hypothetical worker’s most productive years from his or her less productive ones, so asbestos-related deaths among people 65 and over were dropped from this study. Among the 1,169 cases identified, the CDC then developed a scale of “annual years of potential life lost before age 65”, which has been abbreviated to YPLL. This figure is the difference between a person’s age at time of death and 65, so a person who died at 55 had would have a YPLL of 10. The CDC looked at trends within these cases in 5-year periods and they also counted the total YPLL for the entire study period.

As we said above, there were 1169 individuals who died from asbestosis before they were 65. Total years of potential life lost were 7267 YPLL, with a mean YPLL for each person who died of 6.2 years. The CDC also reports that YPLL is increasing over time—even though asbestos use has been heavily regulated since the 1970s. For the first five years under steady (1968-1975), YPLL was 146.0. For the last five years however (2001-2005), YPLL was 239.6: an increase of 64%. While the available data on industry and occupation were a small subset of the total study population statistics, the study also showed that construction, ship building and repair, and military were the hardest hit industries, while insulation workers, and then administrations, plumbers and pipe and steamfitters were the hardest hit occupations.

This study is a further example of the tragedy of asbestos-related diseases in the United States and around the world. Even though regulations regarding the handling of asbestos have been in place for decades now, it’s clear from this study that more and more people are dying from asbestosis.

Scientists from Ohio State University have announced exciting results from a study they were conducting on the manner in which asbestos fibers interact with human cells and, possibly, cause mesothelioma. For the first time in the history of asbestos science, the scientists have identified a particular mechanism by which crocidolite fibers bind to the cell surface of human cells. The scientists are hopeful that an understanding of the molecular biology of fiber and cell interaction will lead to the development of more effective treatments for pleural mesothelioma and peritoneal mesothelioma, as well as asbestos-induced lung cancer.

The findings are still quite preliminary and the scientists caution that any therapeutic development is years ago, but these results are still important as an identification of part of the carcinogenic pathway that leads from asbestos exposure to malignant mesothelioma. Some asbestos fibers are thought to dissolve when exposure occurs, but most do not break down over time, so the identification of the binding mechanism can focus scientists on the particular signaling cascade that occurs after the fiber binds to the cell. An understanding of this cascade could possibly let scientists develop treatments to arrest the growth of the mesothelioma, or possibly, give scientists a target to develop therapies that will prevent mesothelioma’s development in the first place.

The scientists were only studying the crocidolite asbestos, which is also known as blue asbestos, but they hope to expand their study to include the give other common forms of the mineral. Crocidolite is considered among the most carcinogenic forms of asbestos.

State Assets LLC, a building development company based in Brooklyn, NY was fined by OSHA for 18 alleged violations of a number of different health and safety statutes, including statues regulating the handling of asbestos. Alongside the asbestos violations, OSHA also cited the company for violations of fire and electrical codes. The violations allegedly occurred at a New Haven, CT redevelopment site that State Assets was controlling. OSHA alleges that employees were handling asbestos without proper equipment and were put at risk for other work place safety issues.

State Assets has 15 days to respond and/or to contest OSHA’s complaint.

To learn more about this case, please read the full story on the Occupational Health and Safety website: NY Developer Cited for Willful Lack of Asbestos Monitoring.

Life sciences company BTG has licensed its experimental anti-cancer compound, BGC 945, to Onxy pharmaceuticals, who will further develop and commercialize the compound. BGC 945 is an anti-cancer agent in the class of compounds known as TS inhibitors—compounds which derive their cancer treatment effects from the inhibition of thymidylate synthase (TS), an enzyme essential to successful DNA replication and repair. Thus, inhibition of thymidylate synthase can disrupt the processes by which cells divide and replicate, thereby controlling or, hopefully preventing, the growth of cancerous cells. BGC 945 is still in the preclinical stages, but its novel mechanism of action—entering tumor cells through their alpha-folate receptor—has shown promise for the treatment of a number of specific cell types, including mesothelioma cells and lung cancer cells. Alpha-folate receptor is over-expressed in these tumors, as well as a number of other cancers, so therapies that target it may have great promise for their treatment.

As BGC 945 is still in the preclinical stages, its actual efficacy for the treatment of pleural mesothelioma or peritoneal mesothelioma has not yet been tested, but the compound’s unique mechanism of action provides some hope that it may prove effective as a mesothelioma treatment.

A recent issue of the journal Lung Cancer contains an article detailing the results of a study that looked at the efficacy of pemetrexed-based chemotherapy for the treatment of malignant peritoneal mesothelioma. The authors describe their study as the largest one completed that specifically addressed the use of pemetrexed for peritoneal disease. As pleural mesothelioma is the most common form of malignant mesothelioma, most of the clinical trials investigating mesothelioma treatment options are focused on it. Peritoneal mesothelioma is only diagnosed in about 25% of all mesothelioma cases, so the rarity of this form of the disease has limited the study of the treatments specific to it.

Overview of the Study

Many people who are diagnosed with peritoneal mesothelioma are often prescribed the standard treatment course for pleural mesothelioma – pemetrexed plus cisplatin, also known as “Almita Therapy” due to pemetrexed’s trade name as Almita—but studies have not adequately determined its effectivenessfor peritoneal mesothelioma. Because of the disease’s relative rarity, Eli Lilly, makers of pemetrexed/Alimta, and the FDA created the International Expanded Access Program to facilitate the “compassionate use of PEM [pemetrexed] for patients with mesothelioma prior to approval by regulatory agencies.” 109 patients with histologically-confirmed peritoneal mesothelioma were enrolled into this study and were given the standard chemotherapy administration. If patients were not able to tolerate pemetrexed + cisplatin, some were given pemetrexed as a single agent, while others were given pemetrexed + carboplatin, an alternative platinum agent that is often associated with a lessened toxicity profile than cisplatin.

Results

The overall results of the study indicated a response rate of 18.7%, with a disease control rate of 68.1% and a 1-year survival rate of 47.7%. When the results were compared between patients who received pemetrexed as a single agent and those who received pemetrexed in combination with either platinum agent, the results clearly indicated a benefit to combination therapy. Single-agent use was associated with a 12.5% response rate and a 50% disease control rate, while patients who received some form of combination therapy demonstrated a response rate of 22% and a disease control rate of 78%. 1-year survival rates were also higher in patients who received combination therapy: 57.4% vs. 41.5%. Results from the carboplatin group were not reported for this one year survival figure, so the 57.4% was associated with combination therapy using only pemetrexed + cisplatin.

The article also reports that the therapies were well-tolerated. 53.2% of patients completed 6 full cycles of treatment and 20.2% of them completed more than 6 cycles. Pemetrexed has a number of common side effects, but the introduction of folic acid and B12 supplements to the standard administration schedules have improved many of these side effects. The toxicity profiles for the patients in this study were in line with the common pemetrexed profile.

Conclusion

The article concludes by stating that pemetrexed + a platinum agent is an active and well-tolerated chemotherapy regimen for patients with peritoneal mesothelioma, just as it is for patients with pleural mesothelioma. Patients who received the standard regimen were associated with longer median survival and more effective management of the disease’s symptoms than in patients who only received single-agent therapy, or standard palliative care.

The New York Times is running an article on a recently-released study on cancer recurrence rates conducted by the Weill Cornell Medical College in New York that showed delays in starting treatment led to higher rates of recurrence when compared to those who began therapy right away. The researchers analyzed the medical records of more than 8000 patients who were diagnosed with Stage I Breast Cancer and reviewed the success and the recurrence rates among this study population. They found that almost 1 in 5 of the patients 65 and older either delayed the start of radiation treatment or did not complete the full course of therapy and they were able to correlate these findings with increased likelihood of recurrence.

The study, which was published in the journal Cancer, showed that patients who delayed the start of radiation up to eight weeks demonstrated a 1.4 times greater likelihood of recurrence than those who began therapy as soon as it was recommended. When the researchers looked at those who waited 12 weeks to begin therapy, they found an even greater likelihood of recurrence: 4 times greater than those who began therapy as soon as recommended.

The researchers also analyzed the patient population for those who completed a full radiation course, which is usually five to seven weeks, and those who only completed a partial radiation course, which they defined as three weeks or less. Among this latter population, the researchers showed that the risk of “succumbing to cancer” was 32 percent higher than in those who completed the full course.

Whether these results are also representative for mesothelioma or lung cancer patients is an open question, but the study does show the importance of properly following an oncologist’s recommended treatment plan as closely as possible.