Posts Tagged ‘Johann Wolfgang Goethe University of Frankfurt’

A Q&A with Dr. Vogl about mesothelioma trial

16 Jan 2009 by under News, People, Research/Treatment

vogl portait 150x150 A Q&A with Dr. Vogl about mesothelioma trialI know a lot of people who follow this blog are excited about the wonderful results our friend Debbie Brewer has experienced as a result of her participation in a chemoembolization trial in Germany, with her tumor shrinking 53 percent, and now essentially “dead.” The trial is spearheaded by , who is head of the Department of Diagnostic and Interventional Radiology at J.W. Goethe University Hospital at Frankfurt University. He has developed the clinical trial to use chemoembolization to treat mesothelioma.

Because there is so much interest in this clinical trial, even though it is currently only available in Germany, I contacted Dr. Vogl to see if he could provide a little more information about the program.

Q: Explain the basic procedure of chemoembolization / locoregional therapy in the treatment of cancer. How does it work?

A: The basic principle of chemoembolization/locoregional therapy is to achieve a transarterial approach to the tumorous lesion. In the treatment of mesothelioma we have to find the direct supply to the cancer. Then the chemoembolization material can be selectively inserted directly to the lesion. A concentration of cytotoxic drugs of up to 20 times higher can be achieved compared to systemic with reduced adverse events. By cutting off the vascular supply, can be retained in the affected region for several weeks.

Q: How did you learn that this treatment is effective for mesothelioma?

A: During treatment of patients with primary and secondary lung cancer we learned that locoregional therapies are effective for the treatment of mesothelioma.

Q: When did this clinical trial begin? (or how long has it been going on?)

A: The clinical trial started three years ago and will be continued for the next two years.

Q: What are the goals of the clinical trial for this treatment?

A: The goals of the clinical trial are to improve local tumor control, to reduce clinical symptoms like breathing problems and pain, and to increase survival.

Q: How many people with mesothelioma are you currently treating in this clinical trial?

A: Currently we treat 300 to 400 patients with primary and secondary lung cancer per year, and we treat about 20 patients with mesotheliomas.

Q: What are the general / overall results you are seeing in the trials?

A: Clinical symptoms and clinical status of the patients have improved. Local tumor control has improved as well.

Q: What is involved in evaluating a person to see if they are a good candidate for this type of treatment? (What is a good candidate?)

A: Normally we need the following material from the patient before treatment: histology of the cancer, therapy protocols so far obtained, images showing the extension of the tumor. A patient with a localized pleuromesothelioma in one half of the chest is a good candidate.

Q: Explain the procedure for someone receiving this treatment – what happens during a typical treatment visit? How long does it take?

A: After local anesthesia, the femoral vein, which is located in the inguinal region, is punctured. Then a small femoral sheath is usually inserted in the vein through which different catheters can be inserted. After displaying the caval vein, a catheter is pushed forward into the tumor feeding vessels after trespassing the pulmonary arteries. For preventing pain analgetic drugs are administered. Then the chemoembolization as well as the embolizing material are applied. Towards the end of the procedure, the catheters and the sheath system are removed and a compression bandage is applied in order to prevent complications in the inguinal region such as hematoma. After surveillance of 6 to 24 hours, in which complications might be detected and treated, the patient will be discharged. Up to 24 hours after the procedure a CT scan is performed in order to evaluate response to treatment or complications.

Q: How often / frequently does a person receive treatment?

A: The patient normally receives the treatment three up to four times in a 1-month interval.

Q: What are typical side effects of treatment?

A: The typical side effects of the treatment are very low. Normally the patient suffers from fatigue. Nausea and an increasing shortness of breathing are also rarely observed.

Q: How would someone apply to participate in this clinical trial? (Is it still open to receive new patients?)

A: If you send me material (medical reports, MR images, CT scans) I can check it and provide a treatment plan thereafter.

If you are interested in learning more about chemoembolization, or being evaluated for possible inclusion in the clinical trial, you can contact Dr. Vogl here:

Prof. Dr. Th. J. Vogl
Department of Diagnostic and Interventional Radiology
University Hospital
Theodor-Stern-Kai 7
D-60596 Frankfurt

Email: T.Vogl@em.uni-frankfurt.de
Contact telephone number: 0049-69-6301-7277


Debbie’s mesothelioma tumor shrinks!

23 Jun 2008 by under News

debbie and dr vogl 150x150 Debbies mesothelioma tumor shrinks!In April I shared a web site, Mesothelioma and Me, by UK resident Debbie Brewer, who was recently diagnosed with . The site is Debbie’s personal journal about her experiences as she battles , as well as shares stories about her family and daily life.

Some of you who are following Debbie on her journal have already heard the good news – on June 20, she learned that her tumor (which she wittily nicknamed Theo) has shrunk by 10 percent after the first of three scheduled chemoembolization treatments. She had her first treatment May 20, and the second June 20, when she learned Theo had gotten smaller.

According to www.radiologyinfo.org, chemoembolization is a combination of chemotherapy and a procedure called embolization to treat cancer, most often of the liver. According to the web site, catheter embolization is the deliberate introduction of foreign (“embolic”) material such as gelatin sponge or metal coils to stop bleeding or cut off blood flowing to a tumor or arteriovenous malformation.

Debbie traveled to Frankfurt, Germany, to have the procedure, which is still a trial, done by Dr. Thomas J. Vogl, Chairman, Department of Radiology, Department of Diagnostic and Interventional Radiology – University Hospital, Johann Wolfgang Goethe, University of Frankfurt am Main.

In this procedure, Dr. Vogl catheterizes the tumor and administers localized chemotherapy directly into the arteries feeding the tumor. Once the chemotherapy has been administered, other agents can be administered to block off the blood supply to the tumor.

Debbie’s description of the procedure is a little more colorful:

“A small incision will be made to expose the artery that feeds the tumour which is in the femour. A catheter is inserted and pushed up into the area affected. Embolization is a glue like substance which is put in to seal off the tumour and the chemo is then added and the whole area sealed off. The chemo is left to do its job. It is something like having a room with 2 doors, sealing off the back door and throwing in an explosive and sealing up the front door.”

One of the strangest things? The clinic where Debbie visits Dr. Vogl for these treatments is located on a street of the same name as her tumor’s nickname! Theodore Stern Kia 7. Visit Debbie’s blog to read all about her experiences with Dr. Vogl and this treatment. She even has photos of herself at the clinic.

Debbie points out that chemoembolization is not a cure for mesothelioma, but is thought to slow the growth of the tumor or reduce it, allowing the patient a longer life.

In conjunction with or following this treatment, Debbie will undergo a dendritic cell vaccine. According to the web site drugresearcher.com, dendritic cells – a part of the body’s immune system that detects foreign proteins in the body – can be used as vaccines by mixing them with genetic material from the patient’s tumour and infusing the treated cells back into the patient. The dendritic cells present the tumour antigens to the body’s white blood cells (T lymphocytes) for destruction.