AboutMesothelioma.Net

Why Early Detection Is the Best Way to Beat Cancer

Friday, December 26, 2008

Source: Wired.com

Numerous studies have shown that the early detection of cancer is an important factor in maximizing a patient’s long-term prognosis. This is especially the case for aggressive cancers, such as malignant mesothelioma. Even though pleural mesothelioma—and the other forms of the disease, such as peritoneal mesothelioma and the its rarer forms—are not presently curable, the earlier identification of the malignancy usually means that more aggressive treatment can be performed and this has been shown to increase median survival time in most of these patients. The problem is that mesothelioma, like most cancers, is only diagnosed in its later stages, when it is more aggressive and has likely infiltrated larger tissue areas. This has caused some physicians and scientists to rethink the allocation of research monies from strictly curative approaches to ones focused on developing more effective tools for early diagnosis. One such foundation that is dedicated to this platform is the Canary Foundation, who was the subject of a recent article on Wired.com.

The Canary Foundation was started by an ex-executive at Cisco Systems, Don Listwin, who lost his mother to cancer after doctors failed to identify her cancer early enough. It is said that many forms of cancer are 90% curable when diagnosed at an early stage (this is, sadly, not the case with mesothelioma though), but because most research is only focused on curing late stage disease, Mr. Listwin felt it was ever more important to develop better screening structures to identify cancers at earlier times. To this end, he started Canary and positioned it a source of funding for oncologists and other research scientists who are pioneering new ideas for early detection.

Canary has not yet produced any breakthrough results, but the researchers they work with are pushing important boundaries. Whether their results will have demonstrable effects for patients with mesothelioma is unknown, but their work is a cause of hope for everyone whose lives have been touched by cancer.

To learn more about Canary, as well as more about early detection systems, we encourage readers to read the full article at Wired: Why Early Detection Is the Best Way to Beat Cancer.

Labels: cancer, diagnosis

posted by Joseph DiCastro at 4:50 PM
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Finding Chemo: Scanning the Sea Floor for New Drugs

Thursday, December 25, 2008

Source: Wired.com

Researchers and scientists have developed a number of important drugs based on the biological activity of living organisms, such as bacteria and fungi, which are able to fight antigens and diseases like cancer in a variety of interesting ways. Because of these historical successes, the search for organisms with such capabilities is one of the most important areas of contemporary medical research—and the ocean remains the greatest untapped resource for this project. The historical problem in maximizing its utility for this purpose is that even though researchers have long known about the vast abundance of life on the seabed and in deep ocean caverns, technological problems in the extraction, transportation and processing of these microbes have not allowed them to conduct this research on the scale they would like to. Recent advances in technology, however, are playing an increasingly important role in overcoming some of these burdens and researchers are now able to process some of these samples in much more efficient ways. As an example of these new laboratory advances, Wired.com is currently profiling the UC Santa Cruz Chemical Screening Center, a research facility dedicated to analyzing oceanic microbial life and other sea organisms for their use in fighting disease.

The Chemical Screening Center is one of the most advanced laboratories conducting this type of research because it uses automated, robotics-driven testing platforms to perform thousands and thousands of tests each day. After the lab receives sediment and other marine samples from its deep-sea researchers, the robots process the samples against a variety of cultures to look for effects from the samples. Robots can analyze thousands more samples than individual humans ever could, so a much more efficient research methodology is created from these technological advances. For those samples that show any type of activity, human researchers will look at the results, but the robots do the all of the heavy lifting and sorting. In the year the lab has been operational, it has already identified two possible agents warranting further research: a marine bacterium that is 98% effective at killing the parasite that causes African Sleeping Sickness, as well as a compound the lab has dubbed “tamoxilog,” which demonstrates similar biological activity as tamoxifen, a commonly-used chemotherapy drug for breast cancer, but appears more than twice as effective in the lab’s test.

Facilities like the UC Santa Cruz Chemical Screening Center are revolutionizing the practice of medical research and their work is a cause for hope that diseases like malignant mesothelioma will be more effectively treated in the future. None of us can say what the next breakthrough in cancer treatments will be, whether it will be in surgery or chemotherapy or another treatment modality, but we’ve seen a number of great advances in the last twenty years and we can be hopeful that such advances will continue in the future.

Labels: cancer, treatments

posted by Joseph DiCastro at 12:01 AM
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Asbestosis-Related Years of Potential Life Lost Before Age 65 Years — United States, 1968—2005

Wednesday, December 24, 2008

Source: Centers for Disease Control and Prevention

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.

Labels: asbestos, mesothelioma

posted by Joseph DiCastro at 12:03 PM
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Chemoembolisation for Pleural Mesothelioma Treatment

Tuesday, December 23, 2008

Source: Telegraph.co.uk

UK paper The Telegraph is a running a story on a woman named Debbie Brewer, who was diagnosed with pleural mesothelioma in November of 2006 and is being treated with a form of chemotherapy called chemoembolisation, which features a direct application of chemotherapy agents into the malignant areas. Whereas traditional chemotherapy is a systemic treatment where the drugs are injected into the blood stream and circulate throughout the body, with chemoembolisation, the drugs are delivered to the actual tumor cells through a catheter.

Chemoembolisation is more often used for cancers that feature individual tumors with distinct boundaries, as opposed to mesothelioma which is most often characterized by a diffuse spread of malignant cells throughout a surface area. However, for Debbie Brewer, the treatment has been totally effective: the oncologists at the University Clinic in Frankfurt, Germany, the center where she has been treated, have declared her in remission. Because of the success in treating her disease, Debbie is spending Christmas with her family.

Original Title: “Pioneering treatment enables cancer sufferer to spend Christmas with family”

Labels: chemotherapy, mesothelioma, pleuralmesothelioma, treatments

posted by Joseph DiCastro at 10:16 AM
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Gemcitabine Combined With Oxaliplatin in Pretreated Patients with Malignant Pleural Mesothelioma:

Monday, December 22, 2008

Source: Journal of Occupational Medicine and Toxicology

Difficulties in the long term management of malignant mesothelioma are one of the most common topics covered on this site. Even as recent years have seen improvements in our ability to treat patients with pleural mesothelioma and peritoneal mesothelioma, the disease remains without a cure and median survival times are still much too short. This situation has spurred physicians and researchers throughout the world to investigate novel therapeutic options using a number of different agents and modalities. Some of these studies have identified possibly new avenues of treatment, while others have confirmed a similar lack of efficacy as to the standard therapies. In all cases, however, research into creating more effective mesothelioma treatment options continues all over the world.

A paper describing the results of a new chemotherapy regimen was recently published in the Journal of Occupational Medicine and Toxicology. The study under discussion was conducted by researchers from Germany who were investigating the efficacy of chemotherapy involving oxaliplatin monotherapy or oxaliplatin in combination with gemcitabine in patients with pleural mesothelioma who had previously been treated with pemetrexed and a platinum agent.

The study enrolled 29 patients between February 2005 and September 2007 and analyzed their performance along a number of axes, including: response rate, disease control rate, overall survival, time to progression, progression-free survival, time to treatment failure and toxicity.

The authors report survival median survival from the start of treatment at just over 24 weeks (24.3), with overall survival for the patients from original diagnosis at almost 72 weeks (71.7). They also report median time to progression at 9.3 weeks. The article reports that 13 of 29 patients experienced a partial response or stable disease, for a disease control rate of 44.8%, while 55.2% of patients (16 of 29) experienced progressive disease. Toxicity was well managed, with no Grade 4 toxicities noted in the patient cohort.

With a disease control rate of nearly 45% and no grade high level toxicities reported, the authors conclude that until more data on alternative treatments is available oxaliplatin in combination with gemcitabine should be considered an option for patients with relapsed pleural mesothelioma.

Labels: chemotherapy, mesothelioma, pleuralmesothelioma, treatments

posted by Joseph DiCastro at 4:40 PM
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Asbestos, Mesothelioma, and Cancer

Source: Science Daily

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.

Labels: asbestos, mesothelioma

posted by Joseph DiCastro at 11:29 AM
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‘Smart bomb’ Nanoparticles Stop Cancer’s Spread

Saturday, December 20, 2008

Source: Computerworld

We have written a number of recent articles about the impact that nanotechnology is having on cancer treatments and this article continues that recent focus. A multidisciplinary team of scientists and oncologists at the University of California at San Diego have developed a nanoparticle, what they are calling a “smart bomb,” that effectively targets the distant spread of tumor cells by increasing the efficacy by which chemotherapy can de delivered to them. Working on a study involving pancreatic cancer and kidney cancer, the researchers were able to develop a delivery system for the chemo agent doxorubicin that targeted tumors cells that had metastasized to other parts of the body. Metastasis is always a difficult treatment situation and is often the manner by which cancers kill a patient, so developing methods of containing and/or combating it is one of the most pressing topics in contemporary cancer research.

The researchers describe the technology as targeting specific protein markers on the surfaces of metastatic lesions. These tumors are highly dependent on the development of new blood vessels, a process which offers distinct targets for the nanoparticle to bind with and deliver the chemotherapy to. The researchers report that the therapy inhibited the metastatic spread of the cancers in most of the mice under study.

Another benefit to this technology was its much better tolerability than traditional doxorubicin-based treatments of metastatic pancreatic and kidney cancers. Because the delivery mechanism is able to target tumor cells more efficiently, the total dosage level of the doxorubicin can be reduced, even as a higher percentage of the agent is delivered to the malignancy. The researchers report that while previous trials involving doxorubicin often demonstrated significant toxicity among the patients under study, the mice in their tests did not display the same levels of weight loss and system toxicity as is normally seen.

Nanotechnology is truly revolutionizing cancer treatments, but much more work is needed before these research questions are approved for human-based trials and treatments. Hopefully, the day for these trials and treatments is coming soon. With aggressive diseases such as pleural mesothelioma and peritoneal mesothelioma, these new technologies are offing hope for patients and doctors alike.

Labels: cancer, chemotherapy, treatments

posted by Joseph DiCastro at 12:00 AM
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Researchers Use Nanotech to Target Chemo Cancer Treatment

Friday, December 19, 2008

Labels: cancer, chemotherapy, treatments

posted by Joseph DiCastro at 12:00 AM
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Cancer Stem Cells May Not Be the Supervillains We Thought

Thursday, December 18, 2008

Source: Wired News

The hypothesis that most forms of tumor genesis are driven by cancer stem cells has been one of the most exciting ideas in oncology research for a number of years now. The basic theory is that a small number of cells (co-called stem cells) are the principal catalysts for tumor development and treating these specific cells is a more effective method for stopping the growth of cancer than treating the entire tumor. However, the results of a recent study—conducted by an oncologist who has championed the stem cell theory—have cast serious doubt on the viability of this concept for many common cancers.

Sean Morrison, director of the Center for Stem Cell Biology at the University of Michgan’s Life Sciences Institute and the principal founder of Oncomed, a biotech startup focused on cancer stem cell treatments, was studying the growth of melanoma cells in mice and discovered that upwards of 25% of these tumors’ cells were fully tumorgenic—a much higher figure than the stem cell theory predicts. He was quick to note that these findings do not entirely invalidate the model, but they are indicative that many forms of cancer, such as melanoma and solid tumor cancers, do not conform to the stem cell model and treatments that are based on this model will likely be less effective—or not effective at all—for these types of cancers. Mr. Morrison is a highly-regarded oncologist who has long been associated with the stem cell theory, so for him to come to the conclusion that the theory may not be as wide-ranging as hoped is an important development for people who are following the research on this topic.

One of the leading critics of the theory, Steve Kern from John Hopkins, was not surprised by the findings and thinks they are indicative of many of the problems that he, and other critics, have previously noted. However, both Mr. Kern and Mr. Morrison believe that the stem theory may still be applicable for other forms of cancer, such as leukemia, which has a very different oncogenic pattern than carcinomas, sarcomas and other solid tumors. More information about the treatment efficacy of this theory will come out when the clinical trial that is studying Oncomed’s leading drug, OMP-21M18, is completed.

Advances in cancer research during the last ten years have defininitely had positive effects on our ability to diagnose and to treat cancer, and we have all benefited from these advances. Even as the results of this study indicate that no panacea is likely to be found for cancer treatments, the dedication and creativity of our greatest cancer researchers gives us all hope that treatments for seemingly intractable cancers, such as pleural mesothelioma and peritoneal mesothelioma, will be developed in the future.

Labels: cancer, treatments

posted by Joseph DiCastro at 1:56 PM
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MIT Uses Nanotubes to Help Fight Cancer

Wednesday, December 17, 2008

Source: Computerworld

Researchers from the Massachusetts Institute of Technology (MIT) have recently developed nanotech-based sensors that can be placed inside living cells to monitor the efficacy of chemotherapy regimens. The sensors are made from carbon nanotubes that are then wrapped in DNA. This structure enables their injection into living tissues in a safe and effective manner. Once injected, the sensors monitor which tissues are being attacked by chemotherapy and which are being ignored, providing valuable feedback to the treating physicians. The sensors function by giving off light at specific wavelengths, so scientists can track how effective and targeted (or, how ineffective or non-targeted) a treatment has been by detecting the light signatures of the implanted sensors.

Labels: cancer, chemotherapy

posted by Joseph DiCastro at 4:47 PM
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Peritoneal Mesothelioma

Monday, December 15, 2008

Source: Current Treatment Options in Oncology

Peritoneal Mesothelioma is a rare disorder that is diagnosed in only 250-300 patients per year in the United States. However, after pleural mesothelioma, it is still considered the second most-common form of malignant mesothelioma. Due to the small number of new cases, large scale clinical trials have been impossible to perform—a fact which has limited medicine’s ability to develop standardized treatment protocols for patients who develop the disease. Smaller scale research has still been conducted and in the last few years a number of papers on peritoneal mesothelioma have appeared in the literature, some focusing on the disease’s typical behavior and infiltration patterns, some describing the treatment protocols of individual hospitals. All of them, however, demonstrate the determination of physicians and treatment centers to better understand this difficult disease.

An article on peritoneal mesothelioma was recently published in Current Treatment Options in Oncology, an important publication that is focused on the latest research in cancer treatments. The article was authored by physicians from Columbia Presbyterian Hospital in New York City, as well as a member of the Mesothelioma Applied Research Foundation, and contains a review of the recent literature and overall knowledge of the disease, as well as an overview of a various treatment protocols, including the one deployed at Columbia Presbyterian.

This article is a summary of the information contained in the original publication and we recommend that readers seek out the source article to learn more about the specifics of the information we are describing.

Peritoneal Mesothelioma Incidence and Statistics

As we said above, the disease is diagnosed in approximately 250-300 people per year in the United States. With overall new mesothelioma diagnoses numbered 2000 to 3000 per year, this represents 10% to 20% of all diagnoses. Overall age of diagnosis is 65 to 70, with males (54.7%) more likely than females (45.3%) to be diagnosed.

Symptom, Prognosis and Histology of Peritoneal Mesothelioma

The authors state that “the usual presenting symptoms include pain, ascites, weight loss, increasing abdominal girth and/or an abdominal mass” and that “leukocytosis, thrombocytosis and persistent fevers are signs of poor prognosis.” Median survival time for most untreated patients can range from 9 to 18 months, although the authors do mention that certain patient classes have demonstrated regular examples of two year survival.

In terms of histology, epitheloid mesothelioma is the most commonly-seen subtype of the disease, as is also the case with pleural mesothelioma and the other forms of malignant mesothelioma as well. Bi-phasic mesothelioma is not uncommon, but the authors do state that pure sarcomatoid mesothelioma is a rare finding.

Diagnosis of Peritoneal Mesothelioma

As in all forms of mesothelioma, biopsy of affected tissue is necessary to definitively determine a diagnosis of peritoneal mesothelioma. The authors of the article quote a study from Wake Forest University that concluded this form of the disease expresses many of the same cell type markers as pleural mesothelioma, with the exception of epidermal growth factor receptor: EGFR was highly reactive in 92% of the peritoneal mesothelioma cases, while the pleural mesothelioma cases only showed 33% reactivity.

CT is the most commonly used imaging technology for peritoneal mesothelioma diagnosis and can identify large masses and help in determining a treatment strategy. PET can be used, as it commonly is for pleural mesothelioma and most other forms of cancer, for staging purposes and the identification of distant metastases.

Treatment Options for Peritoneal Mesothelioma

The majority of the article is devoted to an overview of the treatment options available to patients with peritoneal mesothelioma. The authors describe the most common single treatments available (surgery, chemotherapy and radiation), as well as a number of specific multimodality protocols. As is the case with pleural mesothelioma, patients must be separated into those who can receive the most effective treatments—which are also the most aggressive—and those who will be treated palliatively.

Surgery alone can rarely, if ever, achieve full removal of the malignancy and is often combined with chemotherapy and radiation to achieve the best results. Chemotherapy can be used for patients who are treated palliatively and for those who are treated aggressively. Radiation is not effective as a single agent, but can be used post-surgery to treat the areas of surgical instrumentation and this has been shown to help prevent tumor seeding into these areas.

There are a number of different multimodality procedures that can be used for patient treatment. Most of them all involve the same three base modalities that were just discussed, but the manner and mode of deployment often varies between institutions. For example, the authors describe some techniques that feature radical, aggressive surgery followed by a fairly limited use of chemotherapy and then they go on to describe their approach at Columbia, which is characterized by a less radical surgical extraction, but a much longer period of chemotherapy. Whereas other protocols may stipulate a 10 day period of regional chemotherapy, their strategy involves 18 weeks of repeated chemotherapy.

Along with the detailed descriptions of various multimodality procedures, the authors also describe some of the emerging and experimental therapies that have been proposed for treatment, including monoclonal antibody therapy, immunotherapy and specifically targeted treatment agents that work on the molecular level of tumor genesis. Much more work is necessary before these procedures are able to be fully deployed, but their existence is indicative of the increasing options available for patients with peritoneal mesothelioma.

Labels: mesothelioma, peritonealmesothelioma, treatments

posted by Joseph DiCastro at 2:49 PM
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Diagnosing Mesothelioma: Medical Imaging

Friday, December 12, 2008

Radiological imaging techniques, such as CT (computed tomography) and MRI (magnetic resonance imaging), are some of the most important technologies used in the diagnosis of most forms of cancer, including malignant mesothelioma, because they allow the visualization of the underlying malignancy without the need for invasive biopsy techniques. However, mesothelioma’s unique morphological presentation can complicate these technologies’ ability to accurately determine the existence and extent of the disease’s infiltration of a person’s organs and tissue structures. Most forms of cancers present as individually identifiable tumors with clear borders and boundaries, so their presence within human tissue can often be identified by means of images alone. Mesothelioma’s typical presentation is quite different. Instead of a single tumor with clear boundaries, pleural mesothelioma and peritoneal mesothelioma are most often characterized by the diffuse spread of malignant tissue along the surfaces of large tissue areas, making a precise demarcation between malignant and non-malignant areas quite difficult. As is so often the case with this tragic disease, the accurate interpretation of these scans usually requires a specialist-in this case, a radiologist-with previous experience diagnosing the disease.

As indicated above, there are a number of different imaging technologies that can be deployed for a mesothelioma diagnosis. The different technologies have their own strengths and weaknesses and some are indicated for mainly diagnostic purposes and others are most commonly used to determine disease stage.

The most commonly used imaging technology in all of medicine is the x-ray, which is also the oldest of the technologies. The x-ray was developed for medical use in 1895, by the German physics professor Wilhelm Conrad Röntgen. X-rays have a number of important diagnostic functions, but they are rarely effective in the determination of mesothelioma. The principle reason for this ineffectiveness lies in x-ray’s poor visualization of soft tissue: the technology simply does not have the necessary resolution to accurately identify the manner in which mesothelioma invades tissue structures. An x-ray may indicate the presence of a pleural abnormality, but it will not be able to identify this abnormality as mesothelioma.

CT (computed tomography) is generally considered the “gold-standard” in the diagnosis of the disease, and is the most commonly prescribed imaging technology for this purpose, because of its ability to visualize the structure of the malignancy. Should an x-ray show some kind of abnormal shadowing, or should a physician suspect mesothelioma due to a patient’s symptoms and/or known exposures to asbestos, the patient will likely undergo a computed tomography scan of the suspected area. If the physician suspects pleural mesothelioma, this will likely be a chest CT; if the physician suspects peritoneal mesothelioma, this will be an abdominal scan. In many cases though, the physician may suspect an altogether different disorder and will be presented with a set of images indicative of mesothelioma.

CT, however, presents its own diagnostic limitations in the determination of mesothelioma. CT is often enough to visualize the presence of the disease, but the technology has known problems in soft tissue contrast, so the full extent of tissue infiltration can be difficult to determine. In these cases, MRI (magnetic resonance imaging) will be deployed, which features a much more accurate determination of tissue infiltration. For most diagnostic cases, CT will be fine, but MRI is especially useful when planning for surgery because it allows the surgeon more accurate images when planning his or her resection strategy.

Another common imaging technology used in mesothelioma treatment is positron emission tomography, known as PET, which is an altogether different technology than CT or MRI. Whereas those technologies are used for their ability to visualize local tissue structures, PET is most commonly used in the staging of the disease to determine if the disease has spread beyond local areas and metastasized to distant areas of the body. If PET determines the presence of distant tumors, the patient will be immediately upstaged and considered to have Stage IV disease, which means he or she will not be eligible for radical surgeries and aggressive treatment modalities. This is an important determination because the mesothelioma treatments that are most associated with enhanced survival are radical and invasive procedures and patients with late stage disease should be treated palliatively and spared the burdens of these aggressive techniques.

CT, MRI and PET are the most common imaging technologies used in the diagnosis and treatment of all forms of malignant mesothelioma. Much research is being conducted on combined modality PET/CT, which is a technology that precisely aligns the two imaging technologies and keeps their results synchronized, but it has not yet been made a standard technology in the diagnosis of the disease.

Labels: diagnosis, mesothelioma, peritonealmesothelioma, pleuralmesothelioma

posted by Joseph DiCastro at 10:41 PM
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NY Developer Cited for Willful Lack of Asbestos Monitoring

Wednesday, December 10, 2008

Source: Occupational Health & Safety

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.

Labels: asbestos

posted by Joseph DiCastro at 5:11 PM
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BTG Licenses Novel Anticancer Compound to Onyx Pharmaceuticals

Tuesday, December 9, 2008

Source: BTG

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.

Labels: mesothelioma, treatments

posted by Joseph DiCastro at 3:46 PM
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Malignant Peritoneal Mesothelioma:Results from the International Expanded Access Program Using Pemetrexed Alone or with a Platinum Agent

Monday, December 8, 2008

Source: Lung Cancer

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 “Alimta 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.

Labels: chemotherapy, mesothelioma, peritonealmesothelioma, treatments

posted by Joseph DiCastro at 6:24 PM
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WA Researchers Close To Cancer Breakthrough

Friday, December 5, 2008

Source: Perth Now

Researchers from Western Australia have recently announced a major advance in how mesothelioma is treated in mice. The scientists discovered that a combination of Imiquimod, a medicinal cream that is used to treat skin cancers, and anti-CD40, an antibody used in the treatment of tumors and other serious conditions, trigged an immune system reaction in the treated mice that attacked the mesothelioma cells. The researchers report that half of the mice were completely cured of the disease—even in advanced cases of mesothelioma. One of the researchers described the treatment’s mechanism of action as “a rampage by dormant killer lymphocytes which attack cancer and at least double survival times.”

Because both of the individual components have already been proven safe, the study’s lead researcher, Dr. Andrew Currie, hopes to begin clinical trials as soon as possible.

Research such as Dr. Currie’s continues throughout the world today and the hope, among physicians and patients alike, is that improvements in the efficacy of mesothelioma treatments will finally lead to a cure for this difficult disease.

Labels: mesothelioma, treatments

posted by Belluck & Fox at 4:00 PM
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Monitoring of Chemotherapy Response in Malignant Pleural Mesothelioma Using Fluorodeoxyglucose Positron Emission Tomography

Thursday, December 4, 2008

Source: Internal Medicine

Malignant mesothelioma typically presents with a unique morphological pattern that complicates the use of radiological imaging in the definitive determination of a diagnosis or the evaluation of treatment response. Unlike most solid tumors that present as (generally) spherical masses with clear boundaries between malignant and non-malignant tissue, mesothelioma’s natural growth behavior is characterized by the diffuse spread of cancerous cells along the surfaces of tissue structures, where the malignancy co-mingles and invades adjacent structures in a way that makes determining the boundaries between non-cancerous and cancerous tissues more difficult than it is for other forms of cancer. CT is still the imaging “gold standard” among mesothelioma physicians, but more accurate and efficient procedures and technologies are regularly being evaluated for this purpose.

One such technology, FDG-PET (fluorodeoxyglucose positron emission tomography) has shown promise for similar purposes among other forms of cancer, but its specific use in the evaluation of treatment response for pleural mesothelioma has not received wide study. PET has a common use in mesothelioma treatment and diagnosis for staging purposes and to examine the body for distant metastases, but its value as an evaluative technology is still in question.

An article on the use of FDG-PET for this purpose has recently been published in the journal Internal Medicine. The authors of the article provide a case report of a man with pleural mesothelioma who they enrolled in study that examined FDG-PET’s ability to evaluate treatment response.

Case Report

In the article “Monitoring of Chemotherapy Response in Malignant Pleural Mesothelioma Using Fluorodeoxyglucose Positron Emission Tomography,” the researchers, all from Japan, describe the presentation of a 56 year-old man with a massive pleural effusion on his right side, who, apart from the dyspnea produced by the effusion, otherwise appeared relatively healthy. After a number of tests, his physicians diagnosed pleural mesothelioma, biphasic subtype, from a biopsy of tissue from his chest well. The physicians started him on a chemotherapy regimen of cisplatin and irinotecan, but after he developed severe diarrhea due to the later agent, he was switched to a regimen involving cisplatin and docetaxel. The man completed this second course of therapy.

He demonstrated a 90 day period of progression-free disease and survived for 320 days, post-chemotherapy.

Overview of Study

When the man presented, the Osaka City University Hospital was involved in a small scale study evaluating the functional use of FDG-PET for patients with pleural mesothelioma. Patients who were enrolled received CT and FDG-PET scans before the start of chemotherapy, between the first and second courses, and then after the second course. The researchers compared the findings of the CT scan, which provided the baseline evaluation of tumor location and extent, with the findings of the PET scan to determine if they could correlate the metabolic response measured by PET to the objective changes in the tumor reflected in the CT scan.

For the man in the case report, they were able to correlate the findings between CT and PET in response to his chemotherapy. The scans were able to relate tumor volume (CT) and metabolic response (PET) from the initial evaluation and to show a related reduction in both findings after the first round of chemo was able to slow the progression of the cancer, as well as a subsequent increase in both after the second course of chemotherapy failed to contain it.

Conclusion

The authors conclude their article with a review of the relevant literature on PET-FDG’s functional efficacy. They note that not enough study has been conducted with large enough study populations to fully determine FDG-PET’s value as an evaluative technology and they note a number of problems and other contra-indications of its use. However, they do note that their findings suggest a possible role for its use in response evaluation for patients with pleural mesothelioma.

Labels: chemotherapy, CT, imaging, mesothelioma, PET, pleuralmesothelioma

posted by Belluck & Fox at 4:55 PM
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Histologic Assessment and Prognostic Factors of Malignant Pleural Mesothelioma Treated With Extrapleural Pneumonectomy

Wednesday, December 3, 2008

Source: American Journal of Clinical Pathology

Preoperative histologic assessment of mesothelioma tissue is one of the primary means by which mesothelioma specialists develop individualized treatment plans. It is commonly known that patients who present with epithelioid mesothelioma typically demonstrate better treatment response and longer survival times than do patients who present with sarcomatoid mesothelioma, so histological analysis is used to determine which patients will be treated with aggressive therapies and which patients will be treated more palliatively. However, a number of recent studies have noted that post-operative assessment of resected tissue is increasingly reclassifying the pre-op histological diagnosis so the value of determining mesothelioma treatment plans based on this preoperative prognosis is increasingly being called into question.

A group of researchers from the MD Anderson Cancer Center at the University of Texas have recently published the results of a small-scale study that looked at the value of preoperative histological assessment and its relationship to a final histological determination made after surgery. While their findings reinforced the notion that sarcomatoid mesothelioma is associated with a worse treatment response, they also showed a very high number of histological reclassifications and called for more study into this question.

Overview of the Study

The researches analyzed the results of 56 patients with confirmed pleural mesothelioma who underwent extrapleural pneumonectomy. The median age of this cohort was 61 years old. There were 50 males and 6 females. Preoperative staging identified 1 case of Stage I disease, 6 cases of Stage II disease, 33 cases of Stage III disease and 14 Stage IV cases. Preoperative histological analysis identified 37 cases of epithelioid mesothelioma, 9 sarcomatoid cases, 6 cases of biphasic mesothelioma and 4 cases where the type was not specified.

When the researchers compared the results of the preoperative histological diagnoses with those of the post-operative analyses they found significant differences between the two. Post-op analysis showed 21 cases of epithelioid mesothelioma, down from 37; 6 cases of sarcomatoid mesothelioma, down from 9; and the biggest change: 28 cases of biphasic mesothelioma, up from just 6 in the preoperative classification. These results showed that preoperative determinations of histological subtype cannot be used in a categorical manner to determine a treatment plan.

The researchers analyzed these results in a number of other ways as well. They showed that patients with sarcomatoid mesothelioma were associated with a 3.1x greater risk of dying from disease-specific symptoms than were patients with epithelioid mesothelioma. They also showed that patients who received some form of post-operative therapy, such as radiation therapy, demonstrated a greater than 70% decreased risk of disease-specific death or recurrence than patients who did not receive post-operative therapy.

Conclusion

Due to the high number of reclassifications, the authors conclude their article by questioning the prognostic value of preoperative histological analysis. They feel that the limited scope of the tissues made available during biopsy do not provide enough sample area to determine treatment strategies, especially because so little is known about the behavior of biphasic tumors. Because of this, they call for more research into the biphasic subtype of malignant pleural mesothelioma.

Labels: diagnosis, epp, mesothelioma, pleuralmesothelioma

posted by Joseph DiCastro at 5:39 PM
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Delay in Cancer Treatment Is Found to Raise Recurrence

Tuesday, December 2, 2008

Source: New York Times

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.

Labels: cancer

posted by Joseph DiCastro at 5:10 PM
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MesotheliomaHelp.net Announces Expanded Information on Mesothelioma Treatments

Monday, December 1, 2008

MesotheliomaHelp.Net announces it has greatly expanded its website section on mesothelioma treatments. The new area has some of the web’s broadest, most full-featured descriptions of the various procedures used to treat pleural mesothelioma. The section provides a general introduction to many of the issues associated with mesothelioma treatment, as well as detailed descriptions of the primary modalities used to treat the disease: surgery, chemotherapy and radiation therapy. The surgical section now includes in depth information on many of the most commonly used procedures deployed for patient treatment. The section on chemotherapy has been similarly expanded and now provides information on general chemotherapy issues and how chemotherapy is used to treat mesothelioma—especially regarding the use of Alimta for mesothelioma treatment, as well as an overview of the different types of chemotherapy drugs that have previously been used to treat the disease. We also provide a broader treatment of how radiation therapy is used in multimodal mesothelioma treatments.

Belluck & Fox started MesotheliomaHelp.net to provide useful information to people who are interested in malignant mesothelioma. We are dedicated to continually expanding our coverage of these issues and to improving the quality of our content. We hope users find these new additions helpful.

Labels: chemotherapy, mesothelioma, radiation, surgery, treatments

posted by Joseph DiCastro at 4:53 PM
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