One of the many mesothelioma community members on Facebook posted a question today about a clinical trial being conducted at the Mesothelioma Center, located at New York-Presbyterian Hospital. MyMeso discussed this clinical trial in a July post. The clinical trial is a program of targeted radiation and chemotherapy protocol for pleural mesothelioma, which is a cancer of the lung’s lining almost always caused by asbestos. In response to the Facebook thread, meso survivor and awareness advocate (read: warrior) Debbie Brewer, who many of you know from her story and updates here (thanks Debbie!), mentioned a similar study currently ongoing in Australia.

Debbie provided a link to a story published in November 2009 by ABC News that outlines the work of specialists at Austin Health Centre in Victoria. The treatment, spearheaded by Dr. Malcolm Feigen, a radiation oncologist at the Centre, uses high doses of radiotherapy, concentrated on specific areas of the lining of the lungs to target mesothelioma tumors.

According to the ABC report, 13 patients participated in a pilot program to test this new targeted radiotherapy treatment. Most had some surgery prior to the radiotherapy treatment, and some also had chemotherapy before or after the treatment, although Dr. Feigen believes the patients showed the most benefit primarily as a result of the radiotherapy regimen.

Participants in the U.S. clinical trial at the Mesothelioma Center receive a multi-modality therapy that incorporates surgery, chemotherapy and radiation therapy in combination.

Listen to the interview with Dr. Feigen about the Australian research, which was broadcast on ABC’s AM morning current affairs program.

There is an ongoing debate in the United Kingdom about whether the country’s Labour department is responsible for compensating workers suffering from pleural plaques. In 2007, the Law Lords ruled that pleural plaques did not qualify for worker’s compensation. Pleural plaques are areas of fibrosis, or scar tissue caused by exposure to asbestos. They are usually found on the inside of the diaphragm.

A champion for the rights of workers who have developed pleural plaques as a result of exposure to asbestos in the workplace is Jarrow MP Stephen Hepburn. In a meeting at the House of Commons on Nov. 27, he argued the issue of pleural plaques is “immensely important” to workers and pensioners, and insisted it is the duty of members of both sides of the House to overturn the “disgraceful and unjust decision by the Law Lords to bar this terrible illness from classification as a designated illness for compensation purposes,” according to a report in The Chronicle.

Hepburn also told the Commons that pleural plaques sufferers are 1,000 times more likely to develop a more serious form of asbestos-related cancer. Mesothelioma is a deadly form of cancer that affects the lining of the chest cavity and lungs (pleural) or the lining of the stomach (peritoneal). It may also rarely affect the lining of the heart (pericardial). There is no known cure for mesothelioma.

During the heated debate, The Daily Mirror reports that statistics were revealed that show mesothelioma rates in the UK have nearly doubled in 10 years. According to the news source, hospitals treated 7,349 cases of mesothelioma in the past year, compared to 3,773 cases during the timeframe of 1998-99. The Mirror calls mesothelioma an “asbestos timebomb,” citing the disease’s long latency period.

The Mirror quotes Hepburn as saying, “We’re seeing the legacy of workers exposed to asbestos in the 1960s.”

There are tons of new educational, outreach and awareness materials now available from the Mesothelioma Applied Research Foundation. If you do not already subscribe, the latest issue of the Foundation’s “Breath of Hope” newsletter is available. The latest issue provides a recap of activities during the International Symposium on Malignant Mesothelioma, which was held in Washington, D.C., in June. The newsletter includes photos from the event and a wealth of information about research and advocacy, as well as personal stories from mesothelioma patients and their families and caregivers.

This issue is available to download online. If you are having trouble downloading the newsletter, or just want an original hard copy, please let me know. I have some extra copies of the newsletter graciously provided to me by the Meso Foundation that I would be happy to send to you. You can also subscribe by visiting the Meso Foundation online at www.curemeso.org. There also is an archive of past newsletters on the site.

Another exciting resource available at the Meso Foundation web site is a video library of presentations from the Symposium. There were so many great speakers, and this is a truly valuable resource for excellent educational information. The video library also provides access to the slides used by conference speakers. There really is a fantastic amount of information here on topics ranging from Advocacy & Advancing the Mission, to Integrative Medicine, Nutrition, Cancer and the Immune System, Peritoneal Mesothelioma, Pleural Mesothelioma, Clinical Trials and much more.

While on the Meso Foundation web site, please join their online Mesothelioma Community, which will allow you to exchange information with others through a Bulletin Board, as well as read a number of blogs touching on a wide variety of topics. You can also subscribe to an e-newsletter that will keep you informed about all the great work the Meso Foundation is accomplishing in its mission to find a cure for mesothelioma.

If you have any questions or need assistance, you may call the Meso Foundation at (805) 456-7272 or call them toll-free at 877-END-MESO.

The results of a study published recently in The Journal of Thoracic and Cardiovascular Surgery supports the use of extrapleural pneumonectomy-based multimodal therapy in carefully selected patients with malignant pleural mesothelioma. The Journal is published by The American Association for Thoracic Surgery.

According to the research summary, the objective of the study was to evaluate the perioperative and long-term outcomes associated with extrapleural pneumonectomy for patients with malignant pleural mesothelioma. Pleural mesothelioma affects the lining of the chest cavity and lungs. Other forms of mesothelioma include pericardial, which affects the lining of the heart and is extremely rare; and peritoneal, which affects the lining of the abdomen. Mesothelioma is atributed almost exclusively to asbestos exposure.

According to the Multimedia Manual of Cardiothoracic Surgery, extrapleural pneumonectomy was introduced in the 1940s for the treatment of extensive infections of the lung and pleural space. Over the past 20 years, the extrapleural pneumonectomy technique has been modified and applied to the treatment of locally advanced malignant pleural mesothelioma, achieving substantial reductions in mortality. The surgery involves the removal of the lung with visceral and parietal pleurae, pericardium and diaphragm.

Researchers selected 70 patients between October 1994 and April 2008 to undergo the procedure. Prognostic factors included age, gender, side of disease, asbestos exposure, histology, positron emission tomography, date of surgery, neoadjuvant chemotherapy, completeness of cytoreduction, lymph node involvement, peioperative morbidity, adjuvant radiotherapy and pemetrexed-based chemotherapy.

The mean age of patients was 55 years. The median survival was 20 months, with a 3-year survival of 30 percent. Analyses showed improved survival for patients with asbestos exposure, negative lymph node involvement, and receipt of adjuvant radiation or postoperative pemetrexed-based chemotherapy.

The study was conducted by physicians from the University of Sydney, Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital; The Baird Institute for Applied Heart and Lung Surgical; Department of Medical Oncology, Sydney Cancer Center, Royal Prince Alfred Hospital; and Department of Radiation Oncology, Sydney Cancer Center, Royal Prince Alfred Hospital; all in Sydney, Australia.

The National Cancer Institute (NCI) Cancer Bulletin on July 14 featured a new clinical trial for a combination immunotoxin and chemotherapy regimen to treat pleural mesothelioma. This is a Phase I Study of SS1 (dsFv)-PE38 Immunotoxin in combination with Pemetrexed Disodium and Cisplatin in patients with unresectable malignant epithelial pleural mesothelioma (NCI-08-C-0026).

The principal investigator for the studay is Dr. Raffit Hassan of the NCI Center for Cancer Research.

According to the NCI bulletin, researchers hope an experimental immunotoxin called SS1 (dsFv)-PE38 (or SS1P) can improve the outcome of patients with unresectable (or inoperable) mesothelioma. Clincial trial information says that SS1P is a “genetically engineered biological agent in which part of a bacterial toxin is linked to an antibody that recognizes the protein mesothelin.”

Mesothelin is the protein found on the surface of epithelial mesothelioma cells and other types of cancer cells. It is hoped that combining SS1P with chemotherapy will lead to increased antitumor activity, as compared with either treatment alone.

“Given the marked synergy between SS1P and chemotherapy in preclinical studies, combining them could potentially result in increased antitumor activity in patients,” Dr. Hassan is quoted in the Bulletin.

For more information, see the Entry Criteria.

Find trial contact information online or call the NCI Clinical Trials Referral Office at 1-888-NCI-1937. The call is toll-free and confidential.

Results at the completion of a Phase II trial researching the treatment of peritoneal mesothelioma indicate a combination of the drugs Alimta (pemetraxed) and Gemzar (gemcitabine) is effective in increasing survival time and controlling disease progression. The findings were published in the July 2008 issue of the Journal of Clinical Oncology and reported by Cancer Consultants, Inc.

According to the report, the study involved 20 patients treated between 2002 and 2004 who received Alimta and Gemzar every 21 days, along with folic acid, vitamin B12 and dexamethasone. Cancer Consultants reports overall response rate was 15 percent, disease control rate was 50 percent, median time to disease progression was 10.4 months and the median survival time was 26.8 months. Additionally, the report notes that toxicities were tolerable.

Cancer Consultants notes that peritoneal mesothelioma makes up less than 20 percent of all cases of mesothelioma, with pleural mesothelioma being more common. Peritoneal mesothelioma is a specific form of mesothelioma that affects the peritoneum, which is the serous membrane that forms the lining of the abdominal cavity.

Pleural mesothelioma is the most common form of the disease, making up about 75 percent of all cases. Pleural mesothelioma affects the outer lining of the lungs and chest cavity.

Because of its relative rarity, there have been few studies of chemotherapy as a treatment for peritoneal mesothelioma, and there are no controlled trials of various treatment options available for peritoneal mesothelioma.

Traditional therapy for peritoneal mesothelioma has involved surgical debulking followed by systemic and/or intraperitoneal chemotherapy.

Cancer Consultants, which delivers educational programs and resources to more than 18 million targeted seekers of cancer information, has been producing and distributing cancer information for patients and professionals since 1998.

The publication notes that this study is one of the first devoted to systemic chemotherapy treatment for peritoneal mesothelioma and as such provides an important baseline for research.

A New York medical center specializing in the treatment of mesothelioma has announced a new clinical trial accepting patients. The Mesothelioma Center within the Herbert Irving Comprehensive Cancer Center at NewYork-Presbyterian Hospital and Columbia University Medical Center is launching a program of targeted radiation and chemotherapy protocol for pleural mesothelioma, a cancer of the lung’s lining that is almost always caused by previous exposure to asbestos.

It is hoped the new treatment will replace or delay the need for the standard treatment in these cases, a pleural pneumonectomy, which involves removal of the lung and which can be extremely debilitating to patients.

According to a press release from the medical center, Dr. Robert Taub, the study’s principal investigator, director of the Mesothelioma Center at NewYork-Presbyterian/Columbia and professor of clinical medicine at Columbia University College of Physicians and Surgeons, says, “Current surgical and chemotherapy treatments of patients with malignant pleural mesothelioma are unsatisfactory, and have not been shown to significantly prolong survival. In this study, we will investigate whether a combination of chemotherapy and radiation targeted directly at the lung’s lining can improve outcomes while avoiding surgery. In addition, this approach has shown to have minimal toxic side effects compared to systemic chemotherapy.”

The Mesothelioma Center is the only one nationwide that is offering this experimental therapy to treat pleural mesothelioma.

The study is being conducted at the Mesothelioma Center within the Herbert Irving Comprehensive Cancer Center at NewYork-Presbyterian Hospital and Columbia University Medical Center. According to the release, participating patients will receive several rounds of targeted chemotherapy using the drugs cisplatin and doxorubicin via surgically implanted catheters. Some patients will be randomly selected to receive additional systemic (intravenous) chemotherapy using the drugs cisplatin and pemetrexed. All patients will receive targeted radiotherapy using the P-32 radioisotope.

Patients may elect to receive additional surgical treatment, including removal of the affected lung lining or lung. Subsequently, patients will be offered outpatient systemic chemotherapy with cisplatin and pemetrexed.

For more information, visit www.hiccc.columbia.edu.

Friday it was announced the European Commission has granted orphan drug status for Arenegyr, an anti-tumor therapeutic drug manufactured by MolMed S.p.A. in the treatment of malignant pleural mesothelioma (MPM).

According to PharmaLive, Arenegyr is a vascular targeting agent with a unique mode of action, and a first-in-class compound in the class of peptide/cytokine complexes able to selectively target the tumor vasculature. Unique biological properties include induction of tumor vascular permeability and normalization, and a direct biological anti-tumor activity.

PharmaLive quotes MolMed’s president and CEO, Claudio Bordignon, as saying, “Orphan drug designation for Arenegyr in mesothelioma represents a fundamental acknowledgement of the interesting early efficacy and safety results achieved in an ongoing Phase II trial, with 53 patients recruited so far, and which we just presented at the ASCO (American Society of Clinical Oncology) Annual meeting 2008.

He went on to say, “The analysis of preliminary study results presented at ASCO, conducted on 41 patients, already gave evidence of substantial clinical benefits in terms of long-lasting disease control and promising survivals in chemo-pretreated mesothelioma patients. In particular, it shows improved overall survival, and nearly doubled progression-free survival with respect to best supportive care data reported in literature.”

Bordignon said consolidated results relating to survival data will be available in December.

There’s an interesting article just posted to Reuters Health that reports a new study indicates risk of asbestos-related cancer decreases after asbestos exposure ends.

However, down at the end of the article, you learn that risk begins to drop FIFTY YEARS after exposure ends. The report also says that it looks like men have the highest risk of developing lung cancer 30-39 years after exposure, and women are at highest risk 20-29 years after exposure. Then risk begins to drop. Begins.

The decline refers to pleural mesothelioma. The report says that the risks for peritoneal mesothelioma continue to rise, even 40 years after exposure has ended.

It’s a puzzling article, since it SOUNDS like good news, but then as you read along it doesn’t really sound all that great.

Check it out here.

Today, April 1, is Asbestos Awareness Day. On a national level, the Asbestos Disease Awareness Organization (ADAO) is working in Washington, D.C., and around the world, to increase awareness and secure a true ban of all asbestos in the United States. Currently, asbestos is allowable in products at 1% or less by weight.

ADAO secured a senate resolution declaring April 1 as Asbestos Awareness Day, and April 1-7 as Abestos Awareness Week. You can visit the ADAO online.

Today also is Asbestos Awareness Day in Montgomery, Alabama, as designated by mayoral proclamation, signed by Montgomery Mayor Bobby Bright. The local effort strives to bring the message of asbestos awareness and education to the community and to bring attention to the national effort to ban asbestos.

Asbestos exposure can lead to asbestos-related disease including asbestosis, lung cancer and malignant mesothelioma. Many symptoms of mesothelioma and other asbestos diseases do not appear for 20 or more years, making it difficult to diagnose early. For this reason, the cancer is often diagnosed in late stages, making it too often deadly.

In the U.S. current statistics show 2,000-3,000 people are diagnosed with malignant pleural mesothelioma each year, and 10,000 Americans or more die each year from all asbestos-related disease.