Mesothelioma Pages

New studies are showing pemetrexed-based chemotherapy drugs may be a good second-line treatment option for mesothelioma patients who used the same drug type as a first defense.

Pemetrexed fights cancer by inhibiting the formation of DNA and RNA in targeted cells. Without DNA and RNA both cancer and regular cells are unable to survive or grow. Although pemetrexed drugs are currently used as a first line of defense against mesothelioma, no relapse treatment has been approved for use.

A study done by Italian researchers published in medical journal Lung Cancer, reported findings on pemetrexed-based chemotherapies to be beneficial in certain instances as a mesothelioma relapse treatment.

In the study discussed, 31 mesothelioma patients who used pemetrexed-based chemotherapy in at least one prior treatment regime were administered the same pemetrexed-type drugs for relapse between 2004 and 2009. All patients were given second-line, same-type treatments at least 3 months after the last dose of prior treatments. Fifteen patients received pemetrexed chemotherapies while 16 received a combination of pemetrexed/platinum treatments.

Forty-eight percent of patients in the study responded well, with shrinking tumors or tumors that stopped growing. A key in the second-line use of pemetrexed-based drugs seemed to be in patient response to first-defense treatment using the same drug type. Patients who responded to the first pemetrexed-based treatments with at least a 12 month progression-free period responded to same-type second-line treatments with another 5.5 months progression-free period, on average. Patients not gaining as much as 12 months progression-free from the first pemetrexed-based treatments, averaged only 2.5 months progression free following same-type second treatments.

Mesothelioma patients average an eighteen-month life expectancy following diagnosis, although survival rates range from six months to five years. A rare cancer, mesothelioma affects about 3000 families in America each year. Mesothelioma is caused almost solely by exposure to the toxic chemical asbestos. If inhaled, asbestos fibers can begin a damaging process in lining of abdominal cavities, which grows into irregularly patterned malignant mesothelioma over several decades.

Mesothelioma treatments include any combination of surgery, chemotherapy and radiation therapy. Non-cancer direct treatment is available for patients wishing to focus on pain management and quality of life. There is no known cure for mesothelioma.

Another study, by Japanese researchers, with similar results was published in the International Journal of Clinical Oncology. Researchers stated that mesothelioma patients who showed good responses to first-time pemetrexid-based drug treatment were more likely to benefit from same-type second-line treatment. Study authors suggested additional research to decide how to best manage mesothelioma relapse cases.

Cancer, chemotherapy and Pharmacology, a medical journal, recently published an article pertaining to a new drug developed in Japan. Japanese researchers are testing S-1 for its potential as a pleural mesothelioma treatment.

S-1 was designed to reduce tumor growth while supporting another anti-cancer drug, 5-FU. Used in Japan, Korea, China and other Asian countries in the fight against gastric cancer, S-1 has been recommended for approval to be used to treat the same in Europe. It is currently not available in the US.

Developed by Taiho Pharmaceutical Company, S-1 goes by its brand name Teysuno.

Studies were done at the University of Tokushima using lab mice. Malignant mesothelioma cells were administered into the chest cavities of the mice and allowed to grow for quite some time. This development time was used to simulate the late stages of mesothelioma that are typically diagnosed in humans—well after original development begins. When given S-1 the mice responded with reduced tumor size and longer survival times.

Mesothelioma is caused almost exclusively by asbestos fibers. Asbestos has been used heavily in the past hundred years around the world and continues to be used in developing countries. Until worldwide asbestos use is stopped completely, mesothelioma case numbers are expected to rise.

If inhaled, asbestos fibers begin the growth of mesothelioma by mutating the cells of lung lining or lining of other abdominal cavities. Tumor systems affecting lung lining are called pleural mesothelioma, while the less common peritoneal mesothelioma affects lining of other abdominal cavities. Patients often have no idea they were exposed to asbestos and never see a specialist until twenty to fifty years later when symptoms start to show. Even then, diagnosis is difficult as signs mirror those of pneumonia and other respiratory conditions.

Mesothelioma treatments include chemotherapy, surgery and radiation therapy when the patient chooses a cancer-direct approach. However, as there is no known cure for mesothelioma, many patients are undergoing palliative care to manage pain and raise quality of life. Life expectancy following diagnosis of mesothelioma averages eighteen months.

Japanese researchers working on the S-1 studies are encouraged by its outcomes so far. They are calling S-1 a possible good drug to control pleural mesothelioma.

Although there are no known curative treatments for mesothelioma, researchers continue to study this rare cancer in hopes of finding a cure. Mesothelioma is characteristically irregular. Mesothelioma development begins after a mutation caused by asbestos fibers. Tumor growth proceeds randomly over a long latency period. Symptoms are typically not recognized until decades after the original asbestos exposure.

Mesothelioma is hard to diagnose, frequently being misdiagnosed as pneumonia or other curable respiratory conditions. This is more often the case when patients do not know they have been exposed to toxic asbestos fibers and have no idea of their potential for mesothelioma development.  Prognosis is grim. Life expectancy following the demonstration of symptoms ranges from six months to several years; average life expectancy is eighteen months.

Recent finds in cancer research, however, may prove helpful in the fight against mesothelioma. Links between lung cancer cells and diabetic drug, metformin, have begun a new phase of cancer research. As part of the Patient Protection and Affordable Care Act of 2010, grants have been issued to several research facilities studying this new link in cancer treatment. Rather than manipulating growth or spread of cancerous cells, cancer’s energy source, glucose, has been targeted.

Working with QTDP (Qualifying Therapeutic Discovery Project) Program funding through Patient Protection and Affordable Care Act of 2010, Cornerstone Pharmaceuticals said, “Just as the body needs nutrients to survive, cancer cells depend on certain nutrients to make energy and to proliferate.” If the cancer’s energy supply can be stopped, growth and spread may stop as well.

Today, mesothelioma treatments consist of an aggressive approach of surgery, radiotherapy and chemotherapy, or palliative care which focuses on pain management. Mesothelioma has proved to be resistant to chemotherapy when aggressive treatments are administered. This new direction in cancer treatment could be a breakthrough for mesothelioma patients who have had little hope in the past.

Agios Pharmaceuticals also received funding through QTDP. With $488,000 in grant money, they are one of the first groups to begin cancer metabolism therapy research. David Schenkein, chief executive at Agios Pharmaceuticals said, “Nutrient supply and deprivation is becoming potentially the next big wave.”

Three thousand Americans die each year from mesothelioma, and that number is believed to be rising. New cancer treatment research with curative potential is a welcome development for thousands of patients and families throughout the nation.

The company MolMed S.p.A, based in Italy, is manufacturing a drug that may be the long awaited cure for the rare cancer mesothelioma. In clinical trials, NGR-hTNF has shown to work against mesothelioma and liver cancers, as well as large tumors in the arms and legs when used in high doses.

The company’s CEO, Claudio Bordignon, said, following trials, “We now have evidence of clinical activity of NGR-hTNF in five different types of solid tumors, adding two more indications, ovarian and small-cell lung cancer to those observed in completed Phase II trials as a single agent in colorectal cancer, liver cancer and mesothelioma.”

While an estimated ninety thousand people suffer from mesothelioma annually worldwide, these patients and their families have not yet proved a financially lucrative market for pharmaceutical companies. However, as the mesothelioma case numbers are continuing to climb in Western nations with many developing countries expected to peak in the next several decades, the incentive may now be upon research groups to begin an aggressive search for a cure.

Mesothelioma is a cancer of the lung lining caused almost exclusively by the toxic fibers of asbestos. In the US the Environmental Protection Agency holds high standards for the use and safe removal of asbestos, commonly used in building materials and industrial manufacturing. These regulations are described in the EPA’s Clean Air Act. In other countries around the world the standards are not so high, if they even exist.

Mesothelioma has a long latency period, typically between twenty and forty years. This waiting period provides a good source for estimating times of peak cases for nations and regions still using asbestos materials.

After treating the first patient in clinical trials using NGR-hTNF, Bordignon said, “We are really proud of this important milestone, as NGR-hTNF may represent a novel treatment option for malignant mesothelioma, a disease with very high unmet medical need. Based on the positive results of a multicentre Phase II trial, this Phase III trial is optimally designed to investigate the full therapeutic potential of NGR-hTNF in the treatment of mesothelioma.”

This is good news for people who have been exposed to asbestos but have not yet been diagnosed with mesothelioma. Although this cancer has an incredibly short life expectancy following diagnosis, there are countless potential patients who have not yet seen signs or symptoms. NGR-hTNF could be just in time for the peak in mesothelioma cases expected around the world.

New treatments and therapies continue to surface in the fight against mesothelioma. As the number of deaths from this rare cancer rises globally, these advances could not come at a better time. It is estimated that fifteen to twenty thousand people suffer with the disease annually worldwide, and three thousand Americans die from mesothelioma each year.

After diagnosis, life expectancy for mesothelioma patients ranges from six months to several years, averaging eighteen months. Typically treated with chemotherapy, mesothelioma has no know cures. Many patients are turning to palliative treatments to focus on quality of life for the short time they have left.

Mesothelioma can take twenty to thirty years to develop, often after workplace asbestos exposure. This means most patients are not being diagnosed with the disease until middle age or later. Health and age are important factors in treatment decisions, not everyone can withstand the toll of surgeries and the harsh effects of chemotherapy.

Five years ago in Boston, Dr. David J. Sugarbaker defied odds when he administered several advanced treatments to a young mesothelioma patient, Karen Grant. Dr. Sugarbaker headed the Mesothelioma Program at Brigham and Women’s Hospital in Boston. He was also the chief of the hospitals Division of Thoracic Surgery and a Richard Wilson Professor of Oncologic Surgery at Harvard Medical School when Grant, just twenty-nine at the time, sought his leadership in her treatment.

Dr. Sugerbaker and his staff began Grant’s treatment with two of the same surgeries to remove cancer tumors and infected tissues from her lungs and lung lining. This surgery, called extrapeleural pneumonectomy, is a typical one for mesothelioma patients that often results in slowed cancer growth and pain relief.

Following the extrapeleural pneumonectomies, Grant under went laser surgery to kill remaining cancer cells in and around her lungs that were not removed in the prior operations. A relatively new treatment was then administered: a chemotherapy bath in which the drug is heated to a certain temperature more potent to the cancer cells and used to soak the infected areas.

Now in her mid-thirties, Grant has shown no signs of mesothelioma in follow-up scans and tests. She may be the first patient to survive this deadly cancer and it’s equally aggressive treatments.

Dr. Sugarbaker’s breakthrough with Grant may be what Dr. Pasi Janne of the Dana-Farber Institute calls “a milestone” on the road to a cure.

Dr. Richard Alexander, Jr., M.D., of the University of Maryland School of Medicine believes peritoneal mesothelioma is a distinctly different disease from the more common pleural mesothelioma, and therefore necessitates it’s own treatment.

Usually caused by asbestos fibers, mesothelioma is a rare cancer which can take twenty to thirty years to develop in the lining of the lungs and abdominal cavities. Most mesothelioma patients have no idea their bodies are harboring the cancer until it is too late to treat anything but the pain. There are no known curative mesothelioma treatments. Early detection is often hindered by the long development time and when the symptoms do begin to show they often mimic treatable disease such as pneumonia.

Mesothelioma is thought to affect three thousand Americans each year and a rising fifteen to twenty thousand worldwide. Ten percent of all known mesothelioma cases in America are specifically peritoneal mesothelioma—a cancer of the lining of the abdomen.  Pleural mesothelioma, the more common type, is a cancer of the mesothelium—the lining of the lungs.

Many physicians are prescribing palliative care for mesothelioma patients. The short life expectancy for patients with mesothelioma is a painful one. Routine chemotherapy treatment brings its own set of negative side effects, which lower the patient’s already failing quality of life.

Dr. Alexander says a growing number of practitioners are choosing multi-modal therapies for the treatment of peritoneal mesothelioma. Typically, this approach begins with surgery to remove as many tumors and affected cancerous tissues as possible. Surgery is followed by chemotherapy.

When chemotherapy is prescribed for pleural mesothelioma, cisplatin if the standard drug administered. Due to its complex tumor pattern, peritoneal mesothelioma is responding to a unique chemotherapy bath. The chemotherapy drug is heated to a temperature that is more affective against the cancerous cells. The cancerous tissues are bathed in the heated solution.

Mesothelioma is a common cancer amongst long-time employees of industries such as shipbuilding and mining. The toxic chemical asbestos, which causes the disease, has long been proved a dangerous heath risk although it has been used in multiple industries for decades. Asbestos materials continue to be used around the world and the number of mesothelioma cases is expected to rise. A growing patient base will necessitate continual advances in treatment and diagnoses of mesothelioma. Dr. Alexander suggests collaborative efforts amongst medical institutions to make positive changes in mesothelioma treatment and patient care.

The American Journal of Respiratory and Critical Care Medicine has published the findings of a study done at Oxford University, which may aid in earlier detection of the rare and fatal cancer, pleural mesothelioma.

English researchers used the biomarker mesothelin, a protein made by the cells of the mesothelium—the lining of the heart, lungs and abdominal cavities, which hosts the cancer mesothelioma. Also called MSLN, mesothelin is normally present on the mesothelium and in the pleural fluid of healthy lining.

The researchers tracked one hundred sixty-seven possible cases of mesothelioma.  They found the mesothelin levels in patients with malignant pleural mesothelioma was 6.9 times higher than mesothelin levels in patients with other types of cancer. The mesothelin levels were also 10.9 times higher in malignant mesothelioma cases than in cases with benign results.

Like many other forms of cancer, mesothelioma is difficult to diagnose. It can take decades to develop and symptoms, when they become recognizable, often mimic diseases as common as pneumonia and influenza. One third of all patients tested for mesothelioma receive inconclusive cytology reports. The need for early detection is a dire one.

Mesothelioma is caused almost solely by fibers of the toxic chemical asbestos. Once diagnosed, the prognosis is always bleak. Patients’ life expectancy following diagnosis ranges from six months to five years, averaging eighteen months. About three thousand Americans suffer with mesothelioma each year, and the fifteen to twenty thousand cases thought to occur each year worldwide is rising.

There are no known curative treatments for mesothelioma. It is routinely treated in the western world with casplatin, a standard chemotherapy drug. Advances continue in palliative care for mesothelioma patients due to the pain and discomfort associated with the disease.

Asbestos use continues around the world, particularly in developing countries where occupational health standards are low and the job market is slim.  A rapidly increasing number of mesothelioma and related chronic and fatal respiratory illness are expected in the near future. In 2009 the World Health Organization estimated ninety thousand cases annually if conditions did not change.

With the staggering rise in mesothelioma cases globally and the grim prognosis, the Oxford University findings are a welcome addition to mesothelioma research. The road from findings to diagnoses, however, will need to be a short one if these studies, and those like it, are to prove an effective response to the growing need.

The number of individuals suffering with mesothelioma is rising around the world. In 2009 the World Health Organization estimated ninety thousand cases globally each year. Developing countries continue to use the disease causing material, asbestos, even though the risks are known. In America the regulations on asbestos use are high, but about three thousand mesothelioma cases still occur annually. Many of these cases, as well as other fatal and chronic conditions, are associated with asbestos exposure in the work place.

Mesothelioma is a cancer of the mesothelium, the lining of the lungs and other thoracic and abdominal organs. Caused by asbestos fibers, which mutate the membrane cells in the lung lining, mesothelioma is an aggressive cancer with a short and painful prognosis. Although it can take several decades for symptoms to be seen, once diagnosed, many patients have only a six to twenty-four month survival time.

Many negative side affects are associated with mesothelioma treatments. Chemotherapy causes several conditions that lower chances for survival. In mesothelioma patients, neotropenia and anemia are common responses to chemotherapy. In these illnesses, the blood looses white and red blood cells, respectively, leaving the patient fatigued, weak and susceptible to infection. Loss of energy and strength from the results of chemotherapy lower quality of life and the patient’s ability to fight the cancer.

With a rising number of patients worldwide, the timing could not be better for new treatment options. AstraZeneca’s new drug raltitrexed, brand name Tomudex ®, is now available for use in Portugal, Hungary and the Czech Republic. Raltitrexed has shown beneficial results in clinical tests when used in conjunction with cisplatin. Cisplatin is a long-standing chemotherapy drug used regularly against mesothelioma.

In clinical testing, patients administered both raltitrexed and cisplatin showed higher response to treatment rates, extended survival times, and longer progression-free survival times than patients given cisplatin alone. On a molecular level, raltitrexed actually does less to the cells than cisplatin, but in this case it works in favor of the patient. Cisplatin ultimately kills the cells it bonds with, without a safeguard against it bonding with healthy cells close to the cancer. Raltitrexed only halts the growth and division of cells. Fast growth and cell division characterizes most cancers, including mesothelioma.

Patients using raltitrexed are experiencing a higher quality of life and longer life expectancy. As palliative and curative treatments advance in the arena of mesothelioma response, raltitrexed may be used in both aggressive and non-aggressive treatment schedules.

Dr. Jennifer Temel of the Massachusetts General Hospital believes that there may be more to palliative care than quality of life improvement. A study in which she was the lead author was recently published in the New England Journal of Medicine. In it, she argues that palliative options could actually improve survival in patients suffering from various cancers, including mesothelioma.

“Integrating palliative care early in the treatment of patients with advanced lung cancer,” states the study, “not only improved their mood and quality of life, it also extended their lives.”

Dr. Temel hopes that other cancer care centers will perform further research pertaining to palliative care in order to confirm, clarify or contextualize her own findings.

Mesothelioma is a terminal cancer caused almost exclusively by exposure to asbestos fibers. While the disease can take several decades to present from the time of initial exposure, once it is diagnosed the prognosis is very grim. Mesothelioma patients can usually expect to survive the cancer for no more than about eighteen months. While the survival time varies with age and eligibility for radical treatments, it virtually never exceeds a few years and often falls within just six months.

Palliative treatment refers to medical treatment regimens aimed at increasing patient comfort rather than destroying malignant tissue. In the case of rapidly progressing, aggressive cancers such as mesothelioma, attempts to destroy the cancer are often fruitless and end instead in dramatically reduced quality of life for the patient. Instead, palliative treatments are offered which treat pain, discomfort, fluid build-up that impedes mobility or respiration, and other unfavorable symptoms. Palliative care allows patients to further enjoy the time they have remaining, and lets them focus on seeing to important issues instead of struggling with unending pain.

Massachusetts General Hospital Center for Thoracic Cancer is well known for their outstanding palliative treatment. The cancer center provides “individualized, compassionate care and the most advanced treatments for patients with thoracic cancers,” which include esophageal cancer, thymoma, and mesothelioma among others. Dr. Temel’s recent study asserts that palliative care may have some therapeutic value in addition to its obvious experiential value.