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- Mesothelin Finding Could Lead to Early Detection of Mesothelioma
- New York Attorney Calls for International Ban on Mesothelioma-Causing Asbestos
- Protein Can be Reliable for Diagnosing Malignant Mesothelioma
- Biomarker Successes Remain Elusive For Mesothelioma and Cancer Researchers
- Avastin May Not be Effective for Breast Cancer, But is Still an Option for Mesothelioma
- Options for Funding Mesothelioma Research
- Golf Outing to Raise Funds for Mesothelioma Research
- 3 Year Mesothelioma Survivor Stays Busy Raising Awareness of the Disease
- MesotheliomaHelp Website Offers Mesothelioma-Related FAQs
- CDMRP System Offers Funding Opportunity to Help Military Mesothelioma Sufferers
Thursday, March 4, 2010
Researchers from Johns Hopkins have created a test that can identify if and when a tumor is coming back after a patient has undergone initial treatment. Blood tests are compared with the unique genetic cancer sequences from the original tumor to tell whether surgeons removed all of the cancerous cells, whether the cancer has spread to other parts of the body, or whether the cancer is coming back. Called the PARE approach, researchers believe the test could be used to develop biomarkers for any cancer including mesothelioma.
Mesothelioma, an unusual form of cancer caused by exposure to airborne asbestos fibers, often has a complex growth pattern making complete surgical removal a very difficult task. The goal of the surgery is to achieve a macroscopically-complete resection, which refers to the removal of all visible tumor cells. Finding hidden cells can be close to impossible making a test like this critical to the treatment of both pleural mesothelioma and peritoneal mesothelioma.
Led by Victor E. Velculescu, MD, PhD, the team found that each patient’s cancer is unique, which is the key to this new test that may revolutionize cancer treatment. The team identified nine unique tumor characteristic rearrangements at the ends of its chromosomes that together serve as the tumor’s fingerprint. PARE is named for this finding: personalized analysis of rearranged ends.
This test is not yet widely available and the cost, around $5,000 per patient, may be prohibitive to some. Johns Hopkins University holds the patent on PARE.
© MesotheliomaHelp.Net. All Rights Reserved. Reprinting or republication of this article or any portion of its content is permitted but must include the MesotheliomaHelp.Net link.
Labels: mesothelioma, treatments
posted by Nancy Meredith at 8:04 AM
Wednesday, March 3, 2010
The makers of Oncolyn, a plant-derived natural anticancer remedy, claim that taking the tablets “caused objective and subjective improvement of patients with different types of cancers,” including mesothelioma.
Mesothelioma is a rare form of cancer typically affecting the lining of the lungs. Primarily caused by exposure to airborne asbestos fibers, most cases of mesothelioma are diagnosed 30 years or more after exposure. The latency period can be as long as 50 years.
Often called “asbestos cancer,” mesothelioma is highly aggressive and is resistant to many standard cancer treatments. Currently there is no known cure for mesothelioma, and the average survival time varies from 4 – 18 months after diagnosis. With such a grim prognosis, looking for ways to live longer and to improve their quality of life, many patients are turning to alternative treatments, natural remedies, and holistic care.
A product derived from three edible plants and a unique immune enhancing botanical extract with anti-carcinogenic and antimutagenic functions, Oncolyn, is touted as helping to reduce and neutralize the toxicity of harmful agents, helping to enhance immune cellular function, enhancing energy and mood levels, and enhancing the protection of leukocytes and platelets.
The makers of Oncolyn studied the effect of Oncolyn with standard chemotherapeutic agents. They found that Oncolyn “causes reduction of tumor size, inhibited vascularity on the surface and in the periphery of implanted tumor fragment and other morphological changes such as karyopyknosis and karyorrhexis consistent with apoptosis.” Apoptosis causes cancer cells to die.
In one study published in Natural Products in Cancer Therapy from a September 2008 symposium, researchers stated that when Oncolyn was used in the treatment of one pleural mesothelioma patient full remission was achieved and ten years later the patient remained cancer free.
Oncolyn was developed by Dr. Arthur H.K. D’Jang of Sante International. Dr. D’Jang is a licensed physician (M.D.) and certified specialist by the American Boards of Pathology (Clinical Pathology & Anatomic Pathology) and Nuclear Medicine and has expertise in Infectious Diseases, Biochemistry and Immunology ( Ph.D.,) Preventive Medicine ( M.P.H.) and Cytopathology.
Oncolyn is produced by Sante International. The drug is not FDA-approved, however, it does hold a U.S. patent.
© MesotheliomaHelp.Net. All Rights Reserved. Reprinting or republication of this article or any portion of its content is permitted but must include the MesotheliomaHelp.Net link.
Labels: mesothelioma, treatments
posted by Nancy Meredith at 7:44 AM
Monday, March 1, 2010
A relatively new minimally-invasive surgical procedure known as Video-Assisted Thoracoscopic Surgery (VATS) that uses fiber-optic imaging to see a detailed view of the pleural cavity and its surrounding tissues offers another surgical option for pleural mesothelioma patients. Using video tools inserted through a small incision in the chest, the surgeon can conduct diagnostic tests or surgery without making incisions large enough to physically see and touch the inside of the patient’s body.
Pleural mesothelioma can be diagnosed with a VATS biopsy. VATS pleurodesis can also be performed on mesothelioma patients. Pleural mesothelioma is a form of lung cancer that is almost always caused by asbestos exposure and is most commonly found in the outer lining of the lungs called the mesothelium.
VATS is useful for many different diagnostic and treatment procedures, and each patient is evaluated to determine whether VATS is an appropriate procedure. According to surgeons at the Mayo Clinic, the best candidates are patients who have not previously had chest surgery as scar tissue from previous procedures can make access into the chest cavity difficult.
VATS offers many advantages over traditional thoracotomy, which uses one larger incision to gain access to the chest.
- Patients may be able to leave the hospital in only one to two days versus close to five days required otherwise
- Patients experience less trauma to the body
- Less pain medication is required
- VATS leaves a smaller surgical scar.
A study reported in Interactive Cariovascular and Thoracic Surgery concludes that VATS decortication (the removal of the visceral pleura encasing the lung) is useful as a palliative measure in advanced malignant mesothelioma, and that drainage of effusion and pleurectomy/decortication improves the quality of life and may increase survival as well.
© MesotheliomaHelp.Net. All Rights Reserved. Reprinting or republication of this article or any portion of its content is permitted but must include the MesotheliomaHelp.Net link.
Labels: mesothelioma, treatments
posted by Nancy Meredith at 8:25 AM
Wednesday, February 3, 2010
The most common chemotherapy treatment for malignant pleural mesothelioma is a combination therapy of cisplatin and pemetrexed. This combination is used as a first-line treatment in patients for which resection (surgery) is not an option, as well as in adjuvant chemotherapy treatment after surgery. This combination is effective, yet it can be toxic with a range of side effects including decreased kidney function.
Malignant Peural Mesothelioma (MPM) is a form of lung cancer that is caused by inhaling airborne asbestos fibers and affects the outer lining of the lungs called the mesothelium. While pleural mesothelioma is not classified as a lung cancer according to the medical defintion, the treatments between lung cancer and mesothelioma are often similar. There is no cure for malignant mesothelioma and the treatments that are used to fight the disease are considered aggressive and can be difficult on the patient.
According to a study in the Journal of Clinical Oncology the combination of
carboplatin, as opposed to cisplatin, and pemetrexed is well tolerated in patients with malignant pleural mesotheliom. “Disease control rate, time to disease progression, and overall survival” were similar to those of patients treated with the standard regimen of pemetrexed and cisplatin.
The choice between treatment with cisplatin or carboplatin for mesothelioma
should be discussed with your oncologist. While carboplatin is often better tolerated, the efficacy of cisplatin is slightly better. If kidney function declines while on cisplatin, a switch to carboplatin is reasonable.
Source:
Journal of Clinical Oncology
Labels: mesothelioma, treatments
posted by Nancy Meredith at 8:00 AM
Friday, January 8, 2010
by Nancy Meredith
With a goal “to identify and develop treatment regimens to improve the quality of our patients’ lives and to eradicate mesothelioma as a life-threatening disease,” doctors and researchers at the University of Chicago Mesothelioma Program are pioneers in the research and treatment of malignant mesothelioma.
Mesothelioma, an unusual form of cancer known to be caused by asbestos exposure, can take up to five decades to be properly diagnosed and is responsible for approximately 3,000 new cases of cancer each year in the United States. Although there is no cure for mesothelioma, it can be treated with varying degrees of success through the use of surgical procedures, chemotherapy and radiation.
The mesothelioma program at Chicago is able to offer patients specialized treatment based on the specific characteristics of their disease. Staffed with oncologists, surgeons, nurses, and imaging specialists, the program focuses on a team approach when treating the patients, and the staff members attend weekly meetings to stay apprised of any changes in cases or in research.
Through their comprehensive and multidisciplinary focus the center has developed many different treatment options and can tailor the right treatment to each mesothelioma patient. The program conducts clinical trials in collaboration wtih the National Cancer Institute, and has a priority of testing new and novel approaches for the treatment of mesothelioma.
Mesothelioma Program Doctors:
- Hedy Kindler, MD
- Ravi Salgia, MD, PhD
- Aliya Husain, MD
- Samuel Armato, PhD
- Phillip Connell, MD
- Heber MacMahon, MD
- Jai Raman, MD
The information on the University’s website was developed through encouragement and assistance by a mesothelioma patient. The information covers basic and detailed information about mesothelioma, information about approved drugs as well as drugs within clinical trials, and treatment options.
© MesotheliomaHelp.Net. All Rights Reserved. Reprinting or republication of this article or any portion of its content is permitted but must include the MesotheliomaHelp.Net link.
Labels: mesothelioma, treatments
posted by Nancy Meredith at 8:00 AM
Wednesday, December 9, 2009
In “Fight Asbestosis Inflammation to Prevent Mesothelioma from Forming ” researchers identified chronic inflammation from asbestosis as a risk for developing mesothelioma.
Below are some suggestions from the book “Life Over Cancer” by Keith I. Block, M.D., for managing inflammation through diet. For patients battling asbestosis, making some dietary changes may not only lead to improved health, but can prevent the development of mesothelioma.
This information is also beneficial for anyone currently undergoing mesothelioma treatments.
Minimize Inflammation “Offenders.” Avoid cigarette smoke, avoid excessive alcohol consumption, maintain a normal bodyweight, and get plenty of sleep.
Exercise – but be careful. If you are not actively exercising, but are planning on getting started be careful of injuries. This could lead to additional inflammation, and this should be kept to a minimum.
Salicylates. Salicylate is a natural anti-inflammatory compound found in foods. While this is the active ingredient in aspirin, it does not prevent clotting or lead to gastrointestial discomfort. Tomatoes, turmeric, and wintergreen are the best sources for salicylates.
Flavonoids. Flavonoids act much the same as Celebrex and other anti-inflammatory medications. Berries such as cherries, raspberries, blueberries and blackberries are very high in flavonoids. Other foods such as spinach, broccoli, sweet potatoes, and zucchini as also rich in flavonoids.
Spices. Whole-leaf types of the following spices also offer anti-inflammatory benefits. Basil, oregano, bay leaves, rosemary, sage, thyme, and mint.
Always check with your physician for information regarding diet and exercise during your mesothelioma and asbestosis treatment. Also check with your physician if you are considering taking supplements.
© MesotheliomaHelp.Net. All Rights Reserved. Reprinting or republication of this article or any portion of its content is permitted but must include the MesotheliomaHelp.Net link.
Labels: mesothelioma, treatments
posted by Nancy Meredith at 2:00 PM
Monday, December 7, 2009
At The Block Center for Integrative Cancer Treatment, Dr. Keith Block, MD, offers cancer patients an innovative method to receive chemotherapy that takes advantage of an individual’s circadian rhythms and allows patients to receive their chemotherapy at a time when it will be most effective and least toxic.
The delivery of chronomodulated chemotherapy is through a portable, computerized pump that fits in a small fanny pack and allows patients to participate in normal daily activities such as walking and yoga while they are receiving their treatments.
Chronomodulated administration of chemotherapy has been shown to be more effective by allowing larger doses with lower toxicity to be delivered. According to Dr. Block, each drug “has an optimal time when it is least toxic and most effective.” In addition, there are times when the cancer cells are more active. Delivering the drugs at the optimal time improves the efficacy of the treatment by being able to kill more cancerous cells while preserving the healthy cells.
Side effects through the conventional method of chemotherapy are often debilitating, leading many cancer patients to stop treatments. Through chronomodulated chemotherapy side effects are minimized and patients are more able and willing to complete their treatments leading to higher success in cancer treatment.
Mesothelioma patients should check with their specialists to determine if this is an option for them. Chronomodulated chemotherapy is not for everyone, and a thorough evaluation of each case is conducted to determine the appropriateness of the therapy.
Dr. Block is Director of Integrative Medical Education at the College of Medicine at the University of Illinois, Chicago, and a member of the National Cancer Institute’s PDQ Cancer Complementary and Alternative Medicine (CAM) Editorial Board in Bethesda, MD.
© MesotheliomaHelp.Net. All Rights Reserved. Reprinting or republication of this article or any portion of its content is permitted but must include the MesotheliomaHelp.Net link.
Labels: mesothelioma, treatments
posted by Nancy Meredith at 11:00 AM
Friday, November 27, 2009
Mesothelioma can be a painful cancer. Over half of the pleural mesothelioma patients experience pain in the chest which can be intense and severe enough to require narcotics to alleviate the pain and discomfort.
Not willing to take any more drugs, some mesothelioma patients are turning to hypnosis as a way to manage their pain. Hypnosis, once shunned by the medical profession, is becoming more popular in clinical settings helping people stop smoking, lose weight, and now, deal with pain.
Hpynotherapy, when performed by a trained specialist, can be a powerful and effective procedure. A hypnotist brings a patient to a state of high concentration allowing him to have a strict focus. The person then “projects” himself to another place or state where he can block pain awareness or substitute other sensations for painful ones.
Hypnosis is considered an unconventional therapy and is often used with other holistic treatments including yoga and meditation. Hypnosis is not effective for everyone.
© MesotheliomaHelp.Net. All Rights Reserved. Reprinting or republication of this article or any portion of its content is permitted but must include the MesotheliomaHelp.Net link.
Labels: mesothelioma, treatments
posted by Nancy Meredith at 11:00 AM
Monday, September 14, 2009
Researchers are seeking 40 patients that have confirmed malignant mesothelioma, who are not candidates for surgery or radiation, to test the drug gefitinib. Gefitinib inhibits cellular growth in cancerous cells by targeting the proteins. The trade name for gefitinib is Iressa.
Malignant mesothelioma is a cancer caused by exposure to airborne asbestos fibers. The fibers are either inhaled or swallowed then travel through the body becoming lodged, resulting in cancer decades later. Often called “asbestos cancer,” mesothelioma is resistant to many current treatments. Currently there is no known cure for mesothelioma, and the average survival time varies from 4 – 18 months after diagnosis.
The study, conducted by researchers at the National Cancer Institute in Bethesda, Maryland, is a Phase II clinical trial to determine the efficacy of the drug for mesothelioma patients. Currently, the drug is used for the treatment of patients with locally advanced or metastatic non-small cell lung cancer (NSCLC), and who have previously been treated with chemotherapy.
Patients involved in the study will receive daily doses of oral gefitinib while being monitored. Clinicians will follow study participants for up to four years.
Labels: ClinicalTrial, mesothelioma, treatments
posted by Nancy Meredith at 1:00 PM
Wednesday, July 29, 2009
By Jennifer Glatt
Seeking treatment at a major medical center that specializes in treating mesothelioma may improve survival odds, according to leading oncologist and mesothelioma specialist Anne Tsao, M.D. As assistant professor and director of the Mesothelioma Program in the Department of Thoracic/Head and Neck Medical Oncology at M. D. Anderson Cancer Center in Houston, Dr. Tsao says that nonspecializing centers may miss some of the symptoms of mesothelioma when the disease is in its earliest stages and focused care can add years to some patients’ lives.
In an interview on “Patient Power,” an Internet radio series, Dr. Tsao said that specialization is crucial in certain types of treatment, such as extrapleural pneumonectomy. Specialized care can be essential in improving symptoms and prolonging survival. “We know that with the grim prognosis with our current treatment modalities, we need to make a breakthrough… and I do believe that systemic therapy with targeted agents is the way to go,” says Dr. Tsao.
Major medical centers are often the hub of emerging technologies, research, diagnostic procedures and treatments, and often are involved in new drug therapies, as well.
According to the MD Anderson Cancer Center’s Web site , “since mesothelioma is such a complex disease, it’s important for patients to receive multidisciplinary care from a team of specialists, possibly including thoracic oncologic surgeons, radiation oncologists, pathologists and pulmonologists.
For a number of reasons, mesothelioma has not been researched very much. A major cancer center that treats hundreds of mesothelioma patients a year will most likely be conducting research that may help patients and eventually lead to a cure.”
To listen to the entire Patient Power episode with Dr. Tsao, visit the Publications section. An informative question-and-answer session with Dr. Tsao can also be found on the MD Anderson Web site.
Labels: mesothelioma, Treatment News, treatments
posted by Nancy Meredith at 2:34 PM
Thursday, May 14, 2009
One of the great questions in contemporary mesothelioma treatment is whether pleurectomy/decortication or extrapleural pneumonectomy is the more effective surgical arm for patients with malignant mesothelioma. Different surgeons hold conflicting opinions on this question, but definitive guidance is still not available to recommend one procedure over the other. In light of this situation, physicians in Germany conducted a study to investigate the specific efficacy of pleurectomy/decortication in multimodality therapy and their results compare favorably with prior studies on the efficacy of EPP and multimodal therapy.
The physicians enrolled 35 patients with histologically-confirmed pleural mesothelioma. The staging breakdown was as follow: ten patients with Stage I disease, 6 with Stage II, 17 with Stage III and 2 patients with Stage IV. 25 Patients presented with epithelioid mesothelioma.
The treatment plan of the study stipulated pleurectomy/decortication as the surgical modality, followed by four cycles of pemetrexed and cisplatin. Radiation therapy to the chest wall and mediastinum commenced four to six weeks after surgery. Of the 35 patients who started the study, 33 completed the full treatment plan. One patient died as a result of the surgery and one died as a result of chemotherapy toxicity.
The study results demonstrated overall median survival at 33.2 months. The 1-year survival rate was reported at 75%, the 2-year survival rate at 61% and the 3-year survival was reported as 43%. Due to these excellent results, the physicians concluded that pleurectomy/decortication is effective in multimodal treatments and they call for large, multi-center studies on this treatment.
The physicians presented their findings on May 3, 2009 at the 2009 European Multidisciplinary Conference in Thoracic Oncology (EMCTO).
Labels: mesothelioma, pleuralmesothelioma, surgery, treatments
posted by Joseph DiCastro at 11:35 AM
Friday, May 1, 2009
Even as recent advances in the treatment of malignant mesothelioma have led to a better long-term prognosis for some patients, physicians have not been able to definitely determine which patient classes have the best overall chances at long-term survival. Early diagnosis and epitheloid histology are typically seen as the best prognostic factors, but variations even exist among patients with these factors. In an attempt to learn more this question, physicians and researchers at Boston’s Brigham and Woman’s Hospital have conducted a number of retrospective gene expression studies using tissue samples from prior patients and the results of a recent prospective study involving 120 patients have confirmed many of their previous findings.
The physicians were able to isolate the relationships among four genes (TM4SF1/PKM2, TM4SF1/ARHGDIA, and COBLL1/ARHGDIA) to determine which patients were the likeliest to experience a better prognosis and which were likeliest to experience a more limited one. The authors report their testing predicted both overall survival and cancer-specific survival and the combination of the gene expression tests with traditional prognostic factors allowed them to create separate classifications of a high-risk group and low-risk group with significant accuracy.
The results of this research are quite promising for mesothelioma treatment and the authors call for more study of their testing methodology to determine its regular applicability to mesothelioma patients.
Labels: mesothelioma, treatments
posted by Joseph DiCastro at 12:41 PM
Thursday, April 30, 2009
One of the primary reasons for the greater effectiveness of contemporary cancer treatments has come from a better understanding of the biological foundations of the tumorgeneic process itself. This research has allowed scientists to develop models that better describe the growth patterns of cancer cells, which has also allowed them to develop therapies that target specific aspects of this process. However, not all forms of cancer have yet benefitted from this type of research. In the case of malignant mesothelioma, for example, much more research is still needed to better understand its developmental biology. Physicians and researchers remain hopeful that more research will lead to more effective therapies, so investigations into its biology are being conducted in labs throughout the world.
One of the active areas of this research involves the analysis of the specific chromosomal structures within mesothelioma cells. Researchers have turned their attention to the unique patterns of translocation and deletion found in these cell types so as to learn more about the genetic changes that lead to their growth. An article on this topic, co-authored by one of the true luminaries in the treatment of mesothelioma— David Sugarbaker of Brigham & Woman’s Hospital in Boston— recently appeared in the journal Interactive Cardiovascular and Thoracic Surgery.
In the article “Chromosomal Deletion in Patients with Malignant Pleural Mesothelioma,” Dr. Sugarbaker and Dr. Siyamek-Miandoab of the New York Medical College describe a study they conducted which looked at the chromosome structures of 40 patients with pleural mesothelioma. Of these patients, 22 demonstrated some evidence of deleted chromosomes, with the most common deletions listed as: 1p, 3p, 6q, 9p and 22q. Prior research has not only identified these areas as the most common among mesothelioma patients, but it has also identified 6q as the location of three separate tumor suppressor genes whose loss has been implicated in mesothelioma genesis. In this study, the authors report that deletions in 6q were the most common (15 of the 22 patients: 68%).
The authors state that greater genomic analysis of mesothelioma cells could identify new avenues of treatment for this tragic disease and they conclude their article with a call for more funding and research on this important topic.
Labels: mesothelioma, pleuralmesothelioma, treatments
posted by Joseph DiCastro at 10:15 AM
Friday, April 24, 2009
MesotheliomaHelp.net has expanded its information section on mesothelioma and lung cancer specialists into one of the most comprehensive treatment resources available for patients with asbestos-related diseases. Our searchable, easy-to-use database contains doctor profiles and hospitals records from every state in America, making it easy for residents of California or New York, for example, to find information on the mesothelioma specialists in their area. The doctor profiles feature overviews of each physician’s practice, as well as contact information and links to the doctor’s official biography. The hospital search provides a listing of cancer centers in every state, and notes which of these centers have treatment sections on mesothelioma and lung cancer. As these diseases are best treated by specialists, we hope our doctor database will make it easier for residents of every state to find the doctors who practice close to them.
Labels: mesothelioma, treatments
posted by Joseph DiCastro at 3:02 PM
Monday, March 2, 2009
Morphotek has announced the beginning of a phase II clinical trial investigating the efficacy of the monoclonal antibody MORAb-009 for the treatment of mesothelioma. The study will evaluate progression-free survival in patients with advanced pleural mesothelioma who are being receiving MORAb-009 in combination with the standard mesothelioma treatment regimen, pemetrexed + cisplatin. The study will also analyze the “safety and anti-tumor activity of MORAb-009 as determined by objective response rate.” Morphotek plans on enrolling more than eighty individuals into the study, which is being conducted at multiple treatment centers around the word.
MORAb-009 is a monoclonal antibody whose mechanism of action inhibits the expression of mesothelin, which is a cell-surface protein highly expressed in mesothelioma, pancreatic cancer and a number of other malignant conditions.
Labels: mesothelioma, pleuralmesothelioma, treatments
posted by Joseph DiCastro at 2:16 PM
Monday, February 16, 2009
Source: NIH News
The development of targeted anti-cancer medications is one of the most important areas of contemporary cancer research. Physicians hope creating agents that are able to select specific cells types over others will lead to treatments that are both more effective and that exhibit less severe side effects. This is especially important for the treatment of mesothelioma, as it remains one of the most difficult of all forms of cancer to treat effectively.
The difficulty for these therapies has always been developing an agent that can effectively differentiate normal from malignant cells. A number of articles investigating a variety of agents and targets have been proposed, but most of these studies have not yet led to the creation of such an agent. However, the results of a recent pre-clinical study conducted by researchers from the National Cancer Institute and the University of Pennsylvania School of Medicine have shown great potential for the creation of such agent.
The treatment involves genetically modifying copies of the body’s T-cells, known as the body’s “killer cells,” to target cells associated with high levels of mesothelin expression. Mesothelin is a protein that is expressed mainly by the various tissues that make up the body’s mesothelium, but it is also highly expressed in certain forms of cancer, such as pleural mesothelioma, peritoneal mesothelioma and the non-small-cell lung cancers. The NCI/UPenn researchers were able to modify T-cells to bind with these mesothelin-expressing cell types and to shrink the tumors associated with them. The study reports that mice bred to develop mesothelioma were injected with the treatment and most saw excellent results from the treatment.
The researchers note that the promising results of their study have led them to plan for human clinical trials investing this agent for the treatment of mesothelioma, and for other cancers as well.
Labels: mesothelioma, pleuralmesothelioma, treatments
posted by Joseph DiCastro at 10:46 AM
Monday, February 2, 2009
Most patients with malignant mesothelioma are only diagnosed with the disease in its later stages, when treatment options are generally limited to systemic chemotherapy. For these patients, combination therapy with pemetrexed and cisplatin is the current standard of care. This treatment has proven effective at extending survival times longer than prior mesothelioma treatments were able to, but it is still not considered a curative solution. At some point during treatment, the therapy’s efficacy breaks down and the disease eventually begins to progress again.
Physicians and researchers have experimented with a number of treatments after pemetrexed ceases being effective, but a standard “second-line therapy” has not yet been discovered. A class of chemotherapy drugs known as histone deacetylase (HDAC) inhibitors are among the latest agents to be tested for this purpose. Histones are proteins that DNA binds with in the formation of chromosomes and are important elements in the regulation of gene expression. Researchers discovered that the inhibition of histone deacetylation can lead to the expression of genes associated with tumor suppression and cell cycle arrest and this spurred the creation of HDAC inhibitors for use in chemotherapy. The FDA has already approved one agent, Vorinostat, for this purpose and another, Belinostat, is being studied as well. Lab studies on HDAC inhibition indicated it may have some anticancer benefits to people with mesothelioma so a group of researchers conducted a phase II study on the use of Belinostat for second-line therapy in patients with pleural mesothelioma. Their results recently appeared in the Journal of Thoracic Oncology, in an article entitled “Phase II Study of Belinostat (PXD101), a Histone Deacetylase Inhibitor, for Second Line Therapy of Advanced Malignant Pleural Mesothelioma.”
Belinostat and Pleural Mesothelioma – Results
The researchers enrolled 13 patients into their study of Belinostat as second-line therapy for patients with pleural mesothelioma. The primary endpoint of the study was to identify an objective response rate among this cohort of patients. The researchers identified the following as secondary endpoints: safety profile, median progression-free survival and overall survival.
None of the patients demonstrated objective tumor response to the treatment, so the researchers closed the study for lack of efficacy. They noted that Belinostat was well-tolerated in all patients and that two patients demonstrated stable disease for a period.
In the conclusion to their article the researchers noted that studies completed during their trial began to note that HDAC inhibition as single-agent therapy was not showing much overall efficacy, but that results in combination regimens were showing greater clinical benefit. Because of this, they state that even though their study did not show benefits for the use of Belinostat as single agent second-line therapy, they recommend further studies investigating the efficacy of HDAC inhibitors and other chemotherapy agents in patients with malignant mesothelioma.
Labels: chemotherapy, mesothelioma, pleuralmesothelioma, treatments
posted by Joseph DiCastro at 11:47 AM
Tuesday, January 27, 2009
Article: Surgery for Malignant Pleural Mesothelioma
Malignant mesothelioma is one of the most difficult diseases in all of medicine to manage effectively. Median survival time typically averages only 12-14 months. For patients lucky enough to receive a diagnosis in the disease’s earliest stages, median survival can sometimes be extended two or three years, but a complete cure remains impossible and the vast majority of people who are diagnosed with pleural mesothelioma or peritoneal mesothelioma will eventually die from the disease. Because of this disappointing situation, physicians and scientists all over the world are searching for more effective treatments. In some cases, this research may focus on the investigation of a novel therapeutic strategy; in other cases, it may focus on improving a current treatment modality or on comparing the effectiveness of competing modalities when a standard-of-care has not yet been established.
One of the most controversial questions in contemporary mesothelioma treatment research concerns the choice of pleurectomy/decortication (P/D) vs. extrapleural pneumonectomy (EPP) for the surgical management of pleural mesothelioma. Both of these treatments are highly invasive procedures and both are properly considered radical surgery, but there is not yet clear guidance on which surgery should be performed for what patient. EPP is considered the more invasive of the two procedures, so some physicians will perform P/D on early-stage patients and EPP on late-stage patients, but a standard does not exist which actually specifies this. In many cases, the question of procedure will be based on a physician’s personal history in treating the disease. A number of retrospective studies have been performed, but direct comparison of their results is impossible due to differences in study design, staging guidelines, reporting and a host of other factors. However, these studies are still helpful for the working physician and many doctors will look at these studies in an attempt to draw some conclusions from their findings.
In an article recently published in the Annals of Diagnostic Pathology, David Rice, MB, BCh, FRCSI, of the MD Anderson Cancer Center, summarized much of the available literature on the treatment of pleural mesothelioma and addressed the controversy of P/D vs. EPP as well. He stated that the goal of any curative surgery should be the removal of all macroscopic evidence of disease, but that the available evidence does not indicate which procedure should be the one deployed for this purpose, because neither shows any greater long-term survival when compared to the other. EPP has demonstrated better rates of local disease control than P/D has and it more readily allows the use of radiation than does pleurectomy/decortication, which are important factors in its favor. However, EPP is also associated with a greater risk of serious side effects and of treatment-related death than is pleurectomy/decortication. It is also associated with a greater likelihood of metastatic spread of the disease. Because of this situation, the choice regarding which procedure is more effective is still an open question. Dr. Rice does say, however, that should physicians be able to stop the metastasic spread of the disease, then EPP would likely lead to longer survival in patients who are able to tolerate it.
Labels: epp, mesothelioma, pd, pleuralmesothelioma, treatments
posted by Belluck & Fox at 5:39 PM
Wednesday, January 14, 2009
Source: New Scientist
New Scientist is running a story on an investigational cancer treatment that cured 90% of the mice who received the therapy. The treatment involved “reprogramming” the mice’s immune system to identify the cancer as an antigen and then attack it as such. The study’s authors claim that variations on the therapy could also be used for other serious disorders, such as type 1 diabetes.
Therapies based on augmenting a patient’s immune system response to disease or other disorders are part of the branch of medicine known as immunotherapy. They are already used to treat a number of conditions and innovative researchers continue to expand their domain of application. One of the great hopes for immunotherapy is the development of vaccines or other treatments in the fight against cancer. Because cancer grows from within a person, the immune system rarely identifies the malignancy as an antigen and generally leaves the tumor alone, allowing it to grow and spread relatively untouched. Therapies that train the immune system to recognize the cancer have been studied and some have shown an ability to fight the cancer, but their efficacy has been limited by the manner in which the treatment is given: the patient’s immune cells are removed from the body and trained to attack the cancer and are then injected back into the person to treat the malignancy. The problem with this method is that most of the re-injected cells—some estimates are as many as 90%—die before they have an effect.
Researchers from Harvard University have developed a new system that accomplishes the same “training” of cells, but does it through an implant. The treatment involves implanting a biodegradable polymer that is encoded with the chemical signature of the cancer and a “danger signal” to tell the body to attack agents with this same signature. When the polymer begins to breakdown, it releases a signaling molecule that starts the “training” process which eventually leads to the immune system organizing T-cells to attack the underlying malignancy.
To test their treatment, the researchers studied two sets of mice infected with an aggressive form of melanoma that usually kills within 25 days. The group that did not receive treatment all developed large tumors and had to be killed, but 90% of the group that received the implant were totally cured.
As is the case with all research, more studies are needed to validate the safety and efficacy of this treatment. However, the success demonstrated by this particular study is certainly a cause for hope that better treatments for diseases such as pleural mesothelioma and peritoneal mesothelioma may be found in the future.
Labels: cancer, mesothelioma, treatments
posted by Joseph DiCastro at 11:28 AM
Tuesday, January 6, 2009
Source: Post-Bulletin
The Minnesota Post-Bulletin is running an article on the Minnesota Partnership for Biotechnology and Medical Genomics, a research partnership comprised of the Mayo Clinic, the University of Minnesota, and the State of Minnesota. The Partnership’s goal is to position Minnesota as a leader in medical research by developing innovative diagnostic and treatment strategies using the latest discoveries in biotechnology and genomics research.
The Partnership is currently involved with a number of important research projects, one of which is exploring the use of virotherapy in the treatment of malignant mesothelioma. Virotherapy is a cutting-edge cancer treatment protocol that uses genetically-modified viruses to target cancerous cells, while leaving healthy ones alone. It is still in the experimental stages, but if successful, virotherapy could lead to more effective and better targeted treatments than many of the current therapeutic modalities. The particular virotherapy project the Partnership has funded is studying the use of an adapted measles virus to deliver mesothelioma treatments. The study is led by Robert Krattzke, M.D., of the University of Minnesota, and Stephen Russell, M.D., Ph.D., of the Mayo clinic, the institution where the measles virus under investigation was developed at.
Labels: mesothelioma, treatments
posted by Joseph DiCastro at 3:52 PM
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
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
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
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
Friday, December 19, 2008
Nanotechnology is the branch of engineering that deals with the creation and construction of ultra small technologies that are measured in nanometers, a unit of length that is equivalent to one billionth of a meter. This is approximately equivalent to the size of individual molecules. Nanotechnology is one of the most cutting-edge areas of contemporary science research and has applications in a number of different industries, but its uses in medicine—especially in regards to cancer treatment—are among the most exciting.
During the summer of 2008, researchers from Stanford University developed an innovative, nanotech-based delivery system for chemotherapy treatment that more precisely targeted tumor cells than traditional delivery methods. The researchers were able to create carbon nanotubes that generally bypassed normal tissues and delivered the chemo directly into malignant cells. The technology works due to the varied sizes of blood vessels in normal cells and in tumor cells. The latter’s vessels are thinner and feature larger, more open areas and holes for drugs to get into than do the former’s vessels. This finding allowed the researchers to develop nanotubes that are too large to be absorbed by normal blood vessels, but are smaller than the open areas of the tumor’s blood vessels. The scientists were able to use smaller overall doses of the chemotherapy agents because a higher percentage of the agent was being delivered to the tumor cells than in traditional chemotherapy. In fact, they report that this new method allowed them to deliver 10 times more medication than normal. The researchers also report that treatment efficacy of the mice under study showed a great improvement: after 22 days of treatment, the mice who received the nanotubes had tumors half the size of those mice treated with traditional delivery methods.
This innovative research gets around one of the most difficult aspects in cancer treatment: the targeting of malignant cells vs. normal cells. Traditional chemotherapy has made a number of advances in the last 10 years, but scientists have found it very difficult to develop truly targeted agents that can easily differentiate between healthy cells and cancer cells. The development of the carbon nanotubes at Stanford has shown great promise for this purpose. Along with more effective treatment of the tumors, another of the benefits of more efficient delivery of the drugs is a reduction in the side-effects that are normally associated with chemotherapy. Even as the development of more modern chemo agents has cut-down the severity of these effects, the broad scope nature of traditional chemotherapy virtually guarantees that normal cells will be caught up in the treatment’s cytotoxic effects. By developing this new delivery system, these researchers are truly paving a new path for future chemotherapy treatment and delivery. Much more work needs to be accomplished before this technology is definitely adopted as safe and effective, but the results of this study, as well as a number of other studies, have shown that nanotechnology will be an important part of the future of medicine.
Labels: cancer, chemotherapy, treatments
posted by Joseph DiCastro at 12:00 AM
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
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
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
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
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
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
Thursday, November 20, 2008
Source: Ars Technica
Organ transplant has revolutionized the treatment of a number of disorders, from various forms of cancer to otherwise diseased, yet non-malignant, conditions as well. There are, however, a number of problems with the practice of organ transplant that can present multiple issues for effective disease management. One problem is a purely quantitative issue: organ transplant requires the availability of organs for transplant – there are a limited number of organs available, so everyone who needs one is unlikely to receive the necessary organ. An even more pressing issue relates to the immune system reaction to a foreign organ: great care must be taken so that the recipient’s body accepts the new organ and does not fight it as a foreign antigen. Much progress has been made on this issue in recent years, but the possibility of tissue rejection always remains.
One of the great promises of stem cell science is the possibility that scientists will be able to “grow” replacement organs made from an individuals’ own cells. This would mean that diseased or otherwise faulty organs could be replaced or healed through the introduction of new tissue that was developed from the individual’s own body, which would remove the possibility of tissue rejection by the immune system. The patient’s body would then see the additional tissue as its own tissue so it would not organize resistance against it.
One of the first examples of the successful engineering of tissue from stem cells has been described in an article published in The Lancet. A Spanish woman with a damaged trachea received a graft of a donated trachea that was treated with her own cells. This treatment involved using her cells to grow new sections of this donated trachea, which was then implanted in her. After a month, physicians were unable to note the difference between her “natural” airways and the donated tissue.
The graft has successfully saved this woman’s lung, and life, and represents a major breakthrough in organ engineering. We are likely still years away from this type of engineering being deployed generally, but the hope among doctors and scientists is that techniques such as these can be deployed for the treatment of a wide variety of conditions, such as mesothelioma and lung cancer.
Labels: treatments
posted by Belluck & Fox at 11:10 AM
Tuesday, October 21, 2008
Source: Journal of Thoracic Oncology
The development of truly curative therapeutic approaches for the treatment of mesothelioma is the “Holy Grail” of contemporary research into malignant mesothelioma. Even as improvements to the available treatments have led to extended patient survival time, the disease is still without cure. The most effective current treatments call for a multimodal therapeutic approach where eligible patients receive surgery, chemotherapy and radiotherapy. Patients treated with these therapies consistently demonstrate the longest median survival times of all pleural mesothelioma patients, but the five-year survival figures are still disappointing. Most patients, however, are not even eligible for these new therapies because the disease is most often diagnosed in its latest stages when surgery is no longer appropriate. For the majority of mesothelioma patients chemotherapy using pemetrexed and cisplatin (Alimta therapy) is the standard of care, but median survival for this patient class is only 10-15 months—an improvement over the historical efficacy in treating mesothelioma, but one that does not approach the tremendous advances that recent years have seen in the treatment of other forms of cancer.
Because of this, many researchers believe that the key to revolutionizing mesothelioma treatment will come from the development of novel therapeutic agents whose mechanisms of action target specific aspects of the disease’s underlying biological behavior. One such agent that is being examined for mesothelioma treatment is an inhibitor of Hsp90 (heat shock protein 90), a “molecular chaperone” protein whose primary function is the mediation and regulation of a large number of other proteins. Hsp90 has been implicated in the development of a number of cancers, so the development of therapeutic agents that inhibit its activity may be an important step in the battle against mesothelioma. Researchers from a number of internationally-renown mesothelioma treatment centers have recently published an article where they report on a study they conducted into the efficacy of Hsp90 inhibition for the treatment of malignant pleural mesothelioma.
Overview of the Study
Heat shock proteins are a family of “chaperone proteins” involved in the maintenance and stability of other proteins. Hsp90 is a particular member of this family whose primary importance is the regulation of proteins involved with signal transduction, the process by which a signal from outside of a cell is converted to a message that can be acted upon inside of the cell. Aberrant activity among signaling pathways is a major factor in the development of cancer and Hsp90 has been implicated as an important factor in this signaling chain.
Two important proteins related to the genesis of mesothelioma are AKT and survivin, both of which are mediated by Hsp90. The signaling pathways associated with them have been implicated in the development of cancer in general, and, in particular, their activity and overexpression can lead to anti-apoptotic effects among constituent cancer cells. Survivin levels, especially, have been implicated in relation to mesothelioma and high levels of it function as an indicator of poor prognosis for patients with the disease.
Prior studies into Hsp90 have shown that its inhibition has a positive effect on direct cancer treatment and on the sensitizing of cancer cells for traditional chemotherapy. The major agent used in these studies is 17-AAG (17-allylamino-17-demethoxygeldanamycin), a small molecule inhibitor of Hsp90. 17-AAG is being studied in phase I and phase II trials for a number of solid tumors and has shown inhibitory effects on the growth of Hodgkin lymphoma cell lines as well, but has received only limited attention in relation to mesothelioma treatment.
To investigate the efficacy of Hsp90 inhibition as a viable treatment option for malignant mesothelioma, the authors treated a series of mesothelioma cell lines with 17-AAG and then analyzed the resulting lines for evidence of cell cycle arrest and suppression of cell growth. They found strong evidence of both.
Their analysis of the treated cell lines showed cell cycle arrest during multiple cycle phases, including the G1 and G2/M phases, which led to the overall suppression of new mesothelioma cells. They also found that the 17-AAG treated cell lines induced apoptosis among mesothelioma cells, likely due to the decreased levels of AKT and survivin that they also discovered among the treated cell lines. These are exciting results for a disease that is universally fatal becuase they point to a new avenue of treatment for researchers to explore.
The authors conclude their article by noting that Hsp90 is a promising target for future treatment agents. Much more research is necessary to better understand the complex biology of mesothelioma and the specific effects that 17-AAG has on these cells, but the identification of a new treatment target is an important development nonetheless.
Labels: mesothelioma, pleuralmesothelioma, treatments
posted by Belluck & Fox at 4:55 PM
Monday, October 13, 2008
Source: International Business Times
ONCONASE is a first-in-class antitumor agent developed by Alfacell that has shown efficacy for the second-line treatment of malignant mesothelioma. Clinical trials involving ONCANASE have suggested a dual mechanism-of-action: the agent has its own specific anticancer activity and it sensitizes tumor cells to the effects of other chemotherapy agents as well. An article describing the underlying biological activity on ONCONASE has recently been published in the journal Cell Cycle. The authors show that ONCONASE derives its therapeutic effectiveness from its ability to target the role played by small interfering RNA (siRNA) in specific types of tumor genesis.
Labels: mesothelioma, treatments
posted by Joseph DiCastro at 10:12 AM
Thursday, October 9, 2008
Source: Pediatric Blood & Cancer
Malignant Mesothelioma is most commonly a disease of the older and the elderly. The vast majority of all mesothelioma diagnoses are for men and women (although, mainly men), older that 55 or 60. However, the disease can, albeit very rarely, affect teenagers and young adults. Because mesothelioma is so rarely seen in these populations, studies are impossible to perform and little is understood about the best treatment regimens or the prognostic indicators involved in determining overall treatability. The only way to share information about these cases is through the publication of individual case reports in medical journals.
Physicians from the Dana-Farber Cancer Institute and from Brigham & Women’s Hospital have recently published an article on their treatment of four pediatric peritoneal mesothelioma cases. The case reports describe how the physcians treated these patients and how each responded to these therapies. They close the article with a number of recommendations regarding the future treatment of pediatric mesothelioma cases.
Case Reports
The authors report on four cases of pediatric mesothelioma:
- A previously healthy 17-year-old female with a number of symptoms, including deep vein thrombosis of the left arm, a left-side pleural effusion and an unknown pelvic mass. Fluid in her peritoneum tested positive for mesothelioma.
- A previously healthy 16-year-old male with pelvic pain and weight loss, among other symptoms, had a biopsy of a diffuse tumor mass in his pelvis which revealed peritoneal mesothelioma.
- A previously healthy 20-year-old male with a Klebsiella pneumonia, pleural effusion and a mass in the tissue surrounding his kidneys tested positive for peritoneal mesothelioma.
- A 16-year-old female with a prior cancer history (neuroblastoma at 12) who had achieved complete remission, presented with abdominal pain that was discovered to be caused by peritoneal mesothelioma.
None of the patients had any personal risk factors for mesothelioma, and none were smokers. However, three of them had fathers who were likely exposed to asbestos during their work in construction. None of the men had any evidence of pleural mesothelioma or peritoneal mesothelioma, but we know that the disease can affect the children and spouses of exposed workers before they are diagnosed, or even if they are never diagnosed.
Treatment Regimen and Response
After the patients were diagnosed with peritoneal mesothelioma, they all received the same basic treatments as an adult would receive. All of the patients received systematic chemotherapy using pemetrexed and cisplatin; two of the patients received surgical debulking prior to their chemotherapy.
The median survival for the group was 40.3 months. At the time the article was published, three of the four were still alive. Two of these were progression free at 45 and 57 months, respectively, while the third demonstrated some progression at 22 months, but will still alive at 24 months.
Conclusion
The authors conclude their article by raising the question as to the relationship between asbestos exposure and the development of either pleural mesothelioma or peritoneal mesothelioma, especially in pediatric cases. They note that while the incidence of the pleural disease is to be expected based on the way in which these exposures occur, the reasons for the development of peritoneal mesothelioma are still unknown. They wonder if the precise nature of the exposures—whatever they may be, as the question remains totally open for these four patients—may explain the development of peritoneal disease in place of pleural disease.
They also conclude that, where applicable, pediatric cases should be treated in the same manner as adult cases are treated: they should receive debulking surgery if possible and intravenous systemic chemotherapy. The authors also believe that these patients should be eligible for enrollment in adult-focused clinical trials.
Labels: mesothelioma, peritonealmesothelioma, treatments
posted by Belluck & Fox at 3:05 PM
Wednesday, October 8, 2008
Source: Clinical Cancer Research
Even as the introduction of combination chemotherapy using pemetrexed and cisplatin(Alimta Therapy) was a watershed event in the history of mesothelioma treatments, research into the disease’s underlying cellular activity has shown that mesothelioma cells demonstrate a natural resistance to most forms of chemotherapy, as well as a natural resistance to apoptosis. This research has postulated that the disease’s anti-apoptotic tendency may be one of the primary reasons for its aggressiveness and its ability to resist long-term management. Therapies using pemetrexed and cisplatin have certainly achieved longer median survival times than previous therapies have achieved, but they are still not a curative solution for pleural mesothelioma or peritoneal mesothelioma. At some point in a patient’s treatment, the chemo agents begin to lose efficacy and the disease eventually overcomes the treatment’s ability to manage it. If this is due to the disease’s natural resistance to apoptosis, then understanding the biological mechanisms responsible for this resistance should offer researchers the chance to develop treatments that account for these mechanisms, which could then lead to the development of more effective therapies than are currently available.
One of the leading genetic candidates for influencing mesothelioma’s apoptotic resistance is p21, a gene that regulates certain aspects of the S phase—the synthesis phase—of the cell cycle. High levels of p21 expression have been implicated in prior research regarding anti-apoptotic behavior and it has been shown to be highly expressed in mesothelioma cell tissues and cell lines.
Researchers in Italy conducted a study where they investigated the relationship between p21 expression and mesothelioma’s resistance or susceptibility to apoptosis and cytotoxic treatment. They found that p21 was expressed within in tumor cells in response to some chemotherapy agents, which may explain why mesothelioma is so resistant to chemotherapy: even as the chemo agents are being absorbed by the cancer cells, the cells are expressing a genetic agent, p21, that increases their resistance to apoptosis, and therefore, the cytotoxic effects of chemotherapy.
The researchers found that if they could disrupt the expression of p21 in these cells then the cytotoxic effects of the chemotherapy agents they were studying were greatly enhanced. Their results were so successful that they are now calling for more research into the effects of p21 expression in mesothelioma and, specifically, the study of novel therapeutic techniques to inhibit its expression among mesothelioma cells.
Labels: chemotherapy, mesothelioma, treatments
posted by Belluck & Fox at 5:10 PM