Mesothelioma is a form of cancer caused by exposure to asbestos.To get more information about mesothelioma symptoms, diagnosis, treatment options, mesothelioma news and resources for dealing with the cancer mesothelioma or call us at 1.866.855.1229 .
Ultrasound Technology as a Novel Treatment Strategy in Pancreatic Cancer_Crim...CrimsonpublishersCancer
Adenocarcinoma of the pancreas (PDAC) accounts for 2.4% of all cancers diagnosed and is the fourth leading cause of cancer death, with almost equal rates of incidence and mortality [1]. By 2030, pancreatic cancer is projected to be the second leading cause of cancer-related death [2], surpassing breast, prostate and colorectal cancer. The overall survival at 5 years of around 7.2% as the majority of patients present with advanced disease at diagnosis. Patients with localized disease are treated with surgery, with or without neoadjuvant chemotherapy/ radiotherapy, followed by adjuvant chemotherapy. The majority (around 80%) of patients are treated only with chemotherapy as they have an advanced disease. Patients are treated in the first line with gemcitabine-abraxane or Folfirinox and with Naliri plus 5FU in the second line. There have been few clinical advances in PDAC treatment over the last 20 years and chemotherapy is the only treatment option available for the majority of patients. These tumours are also resistant to many targeted therapies such as anti-EGFR therapy like cetuximab [3] due to the presence of a KRAS mutation in the majority of primary tumors. Personalized medicine strategies have not yet been established in pancreatic cancer as in other more common tumour types. Thus, novel anti-tumour strategies are an important clinical need in order to improve survival rates.
We know that mesothelioma patients would rather stay local when receiving treatment,rnso we will review options for private medical centers, surgical consultants, clinical trials,rnand match you up with friendly, local physicians wherever we can.
Our alternative 3E – Program is based on what people have actually done to survive cancer. We have learned from them and have incorporated this knowledge into our 3E program. Treating cancer with alternative strategies and without chemotherapy has become a possibility for an ever-increasing number of people.
Chemotherapy 'vastly underutilized' in bladder cancerYael Waknine
A major weapon in the armamentarium against bladder cancer — neoadjuvant chemotherapy (NACT) — is rarely used in clinical practice, according to a large population study published online April 14 in Cancer.
Researchers analyzed 2944 patient records from the Ontario Cancer Registry, and found that a mere 4% of patients, on average, received standard-of-care NACT prior to cystectomy for muscle-invasive bladder cancer from 1994 to 2008.
Surprisingly, the popularity of adjuvant chemotherapy (ACT) rose over the same period; it was 16% from 1994 to 1998, 18% from 1999 to 2003, and 22% from 2004 to 2008.
Moreover, the controversial ACT was linked to benefits deemed "probably on the same order of magnitude" as NACT (all-cause mortality hazard ratio [HR], 0.71; 95% confidence interval [CI], 0.62 - 0.81; cancer-related HR, 0.73; 95% CI, 0.64 - 0.84), after relevant patient- and disease-related characteristics were controlled for.
Ultrasound Technology as a Novel Treatment Strategy in Pancreatic Cancer_Crim...CrimsonpublishersCancer
Adenocarcinoma of the pancreas (PDAC) accounts for 2.4% of all cancers diagnosed and is the fourth leading cause of cancer death, with almost equal rates of incidence and mortality [1]. By 2030, pancreatic cancer is projected to be the second leading cause of cancer-related death [2], surpassing breast, prostate and colorectal cancer. The overall survival at 5 years of around 7.2% as the majority of patients present with advanced disease at diagnosis. Patients with localized disease are treated with surgery, with or without neoadjuvant chemotherapy/ radiotherapy, followed by adjuvant chemotherapy. The majority (around 80%) of patients are treated only with chemotherapy as they have an advanced disease. Patients are treated in the first line with gemcitabine-abraxane or Folfirinox and with Naliri plus 5FU in the second line. There have been few clinical advances in PDAC treatment over the last 20 years and chemotherapy is the only treatment option available for the majority of patients. These tumours are also resistant to many targeted therapies such as anti-EGFR therapy like cetuximab [3] due to the presence of a KRAS mutation in the majority of primary tumors. Personalized medicine strategies have not yet been established in pancreatic cancer as in other more common tumour types. Thus, novel anti-tumour strategies are an important clinical need in order to improve survival rates.
We know that mesothelioma patients would rather stay local when receiving treatment,rnso we will review options for private medical centers, surgical consultants, clinical trials,rnand match you up with friendly, local physicians wherever we can.
Our alternative 3E – Program is based on what people have actually done to survive cancer. We have learned from them and have incorporated this knowledge into our 3E program. Treating cancer with alternative strategies and without chemotherapy has become a possibility for an ever-increasing number of people.
Chemotherapy 'vastly underutilized' in bladder cancerYael Waknine
A major weapon in the armamentarium against bladder cancer — neoadjuvant chemotherapy (NACT) — is rarely used in clinical practice, according to a large population study published online April 14 in Cancer.
Researchers analyzed 2944 patient records from the Ontario Cancer Registry, and found that a mere 4% of patients, on average, received standard-of-care NACT prior to cystectomy for muscle-invasive bladder cancer from 1994 to 2008.
Surprisingly, the popularity of adjuvant chemotherapy (ACT) rose over the same period; it was 16% from 1994 to 1998, 18% from 1999 to 2003, and 22% from 2004 to 2008.
Moreover, the controversial ACT was linked to benefits deemed "probably on the same order of magnitude" as NACT (all-cause mortality hazard ratio [HR], 0.71; 95% confidence interval [CI], 0.62 - 0.81; cancer-related HR, 0.73; 95% CI, 0.64 - 0.84), after relevant patient- and disease-related characteristics were controlled for.
Hussein Tawbi, MD, PhD provides information on molecular testing and targeted therapy for melanoma at the 2017 MD Anderson Melanoma Patient Symposium held in Austin, TX on May 6, 2017.
Dr. Jennifer Wargo presents the latest on research biopsies and translational research in melanoma at the MRF's Patient Symposium at MD Anderson Cancer Center on January 31, 2015.
Optimal Treatment for Clinically Node Positive Prostate Cancer -A Brief Analy...Kanhu Charan
Optimal Treatment for
Clinically Node Positive
Prostate Cancer -A Brief
Analysis of NCCN
guideline, RTOG study,
NCDB [national cancer
database] and Cancer
Network Review
Abstract
Metastatic gastric tumors (MGTs) mean the tumor cells that attack the stomach and grow there through blood vessel, lymph vessel, and other pathway, consistent with the primary tumor in phenotype, which are clinically uncommon, and information on MGTs is generally limited to single case reports. Here we present a clinical series of 8 cases with MGTs, in attention to discuss the clinical characteristics, diagnosis and treatment, and prognosis of MGTs. Our data showed that MGTs are rare, with a male predominance, and the cause of death was multiple organ metastases in most cases. Heterochromous MGTs showed a significantly better prognosis than simultaneous MGTs, and a long interval between initial radical excision of the primary tumor and appearance of gastric metastasis was found to be associated with good prognosis.
The Influence of Transurethral Resection of Bladder Tumor on Staging of Bladd...asclepiuspdfs
Introduction: Bladder cancer is common, expensive, and the number of cases rising with increased survival in the elderly population. Most centers do computed tomography (CT) scan at the point of investigation, and some will carry this out along with magnetic resonance imaging (MRI) scan to have better local staging once the diagnosis of invasive cancer is made. Any surgical procedure would have a likelihood of influencing local staging, and this is a common belief without any evidence. Methods: We have retrospectively analyzed our data to see where the truth lies. We have compared the final pathology of 236 radical cystectomy patients to the staging reports of 241 CT scans and 65 MRI scans. Results: We have ascertained accuracy, sensitivity, and specificity and whether they were influenced by the timing of the transurethral resection of bladder tumor (TURBT). There was no significant difference between CT and MRI and the timing of the TURBT. Conclusion: This is the first report in the literature outlining the influence of TURBT. We accept the limitation due to the retrospective nature, small sample size, and variability of the biology of bladder cancer.
We know that mesothelioma patients would rather stay local when receiving treatment,rnso we will review options for private medical centers, surgical consultants, clinical trials,rnand match you up with friendly, local physicians wherever we can.
Neoadjuvant rh-endostatin, docetaxel and epirubicin for breast cancer: effica...Enrique Moreno Gonzalez
Recombinant human endostatin (rh-endostatin) is a novel antiangiogenesis drug developed in
China. Previous experiments have shown that rh-endostatin can inhibit the proliferation and
migration of endothelial cells and some types of tumor cells. In this study, we evaluated the
efficacy and safety profiles of combination therapy of rh-endostatin and neoadjuvant
chemotherapy for breast cancer patients in a prospective, randomized, controlled, phase II
trial.
How patient subpopulations are changing the commercialization of oncology pro...IMSHealthRWES
An excerpt from the latest issue of AccessPoint, looking at how genomic profiling data is transforming our understanding of patient subpopulations - a key to targeting treatments with greater precision
Hussein Tawbi, MD, PhD provides information on molecular testing and targeted therapy for melanoma at the 2017 MD Anderson Melanoma Patient Symposium held in Austin, TX on May 6, 2017.
Dr. Jennifer Wargo presents the latest on research biopsies and translational research in melanoma at the MRF's Patient Symposium at MD Anderson Cancer Center on January 31, 2015.
Optimal Treatment for Clinically Node Positive Prostate Cancer -A Brief Analy...Kanhu Charan
Optimal Treatment for
Clinically Node Positive
Prostate Cancer -A Brief
Analysis of NCCN
guideline, RTOG study,
NCDB [national cancer
database] and Cancer
Network Review
Abstract
Metastatic gastric tumors (MGTs) mean the tumor cells that attack the stomach and grow there through blood vessel, lymph vessel, and other pathway, consistent with the primary tumor in phenotype, which are clinically uncommon, and information on MGTs is generally limited to single case reports. Here we present a clinical series of 8 cases with MGTs, in attention to discuss the clinical characteristics, diagnosis and treatment, and prognosis of MGTs. Our data showed that MGTs are rare, with a male predominance, and the cause of death was multiple organ metastases in most cases. Heterochromous MGTs showed a significantly better prognosis than simultaneous MGTs, and a long interval between initial radical excision of the primary tumor and appearance of gastric metastasis was found to be associated with good prognosis.
The Influence of Transurethral Resection of Bladder Tumor on Staging of Bladd...asclepiuspdfs
Introduction: Bladder cancer is common, expensive, and the number of cases rising with increased survival in the elderly population. Most centers do computed tomography (CT) scan at the point of investigation, and some will carry this out along with magnetic resonance imaging (MRI) scan to have better local staging once the diagnosis of invasive cancer is made. Any surgical procedure would have a likelihood of influencing local staging, and this is a common belief without any evidence. Methods: We have retrospectively analyzed our data to see where the truth lies. We have compared the final pathology of 236 radical cystectomy patients to the staging reports of 241 CT scans and 65 MRI scans. Results: We have ascertained accuracy, sensitivity, and specificity and whether they were influenced by the timing of the transurethral resection of bladder tumor (TURBT). There was no significant difference between CT and MRI and the timing of the TURBT. Conclusion: This is the first report in the literature outlining the influence of TURBT. We accept the limitation due to the retrospective nature, small sample size, and variability of the biology of bladder cancer.
We know that mesothelioma patients would rather stay local when receiving treatment,rnso we will review options for private medical centers, surgical consultants, clinical trials,rnand match you up with friendly, local physicians wherever we can.
Neoadjuvant rh-endostatin, docetaxel and epirubicin for breast cancer: effica...Enrique Moreno Gonzalez
Recombinant human endostatin (rh-endostatin) is a novel antiangiogenesis drug developed in
China. Previous experiments have shown that rh-endostatin can inhibit the proliferation and
migration of endothelial cells and some types of tumor cells. In this study, we evaluated the
efficacy and safety profiles of combination therapy of rh-endostatin and neoadjuvant
chemotherapy for breast cancer patients in a prospective, randomized, controlled, phase II
trial.
How patient subpopulations are changing the commercialization of oncology pro...IMSHealthRWES
An excerpt from the latest issue of AccessPoint, looking at how genomic profiling data is transforming our understanding of patient subpopulations - a key to targeting treatments with greater precision
Know More About Asbestos and Mesotheliomajacksouthe
People continue to be exposed to asbestos worldwide, which has been linked to mesothelioma and other diseases. Learn more online from mesotheliomanews.com.
This was the brochure used in the land entitlement project. It was used to introduce the project to the residence and officials in Yorba Linda, California
Long live the business model. What Is The Difference Between a Business Plan And a Business Model? Business plans are static and based on unknowns. A business model describes the rationale of how an organization creates, delivers, and captures value
We know that mesothelioma patients would rather stay local when receiving treatment,rnso we will review options for private medical centers, surgical consultants, clinical trials,rnand match you up with friendly, local physicians wherever we can.
We know that mesothelioma patients would rather stay local when receiving treatment,rnso we will review options for private medical centers, surgical consultants, clinical trials,rnand match you up with friendly, local physicians wherever we can.
We know that mesothelioma patients would rather stay local when receiving treatment,rnso we will review options for private medical centers, surgical consultants, clinical trials,rnand match you up with friendly, local physicians wherever we can.
We know that mesothelioma patients would rather stay local when receiving treatment, rnso we will review options for private medical centers, surgical consultants, clinical trials,rnand match you up with friendly, local physicians wherever we can.
We know that mesothelioma patients would rather stay local when receiving treatment,rnso we will review options for private medical centers, surgical consultants, clinical trials,rnand match you up with friendly, local physicians wherever we can.
This intro is geared towards interested novices who wish to find a resource that can serve as a starting point for further self-study. This is not meant to replace a doctor's advice. Please approach a medical professional for any health condition.
Integrative Cancer - New theories and Advances in Treatment From Hippocrates ...Sheldon Stein
Professor Serge Jurasunsas' recent paper on Integrative Cancer, From Hippocrates to the Human Genome - posted on his behalf. Discusses testing, protocols and case discussion.
Crimson Publishers-Immunological System Cellular: CD8 Lymphocytes in Children...CrimsonpublishersMedical
Immunological System Cellular: CD8 Lymphocytes in Children and Adolescents with Cancer in Cochabamba, Bolivia by Maria del Rosario Davalos Gamboa* in Research in Medical & Engineering Sciences
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stockrebeccabio
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stock
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Study of mesothelioma
1. Surviving Mesothelioma
According to the American Cancer Society, up to about 10 percent of
people with malignant mesothelioma live at least five years after the
disease is diagnosed. While that leaves miles of room for
improvement, the statistic nevertheless means that a substantial
fraction of patients are surviving mesothelioma—a fraction that is
likely to grow with each passing year.
That’s because survival figures for mesothelioma, as well as for
other cancers, are based on outcomes of patients in the past, who
received whatever treatment was available back when they first learned of their
mesothelioma diagnosis. Even minor innovations in surgery or postoperative care, as well as
more substantial advances in chemotherapy or other medicines, can immediately benefit
individual patients. That impact, though, can take years to begin to show up in average
survival statistics. For instance, the mesothelioma treatment pemetrexed disodium (Alimta),
which is given with another chemotherapy drug to patients who aren’t candidates for
surgery, received U.S. government approval just seven years go, meaning that any ability
to nudge up survival statistics is only beginning to appear.
In the broader war on cancer, there is even more reason for hope. In the war on cancer,
many powerful weapons are in development, and in some cases, already on the battlefield.
Consider a rare cancer of the white blood cells known as chronic myeloid leukemia (CML).
Until the introduction of a new drug, called imatinib (Gleevec), in the United States in 2001,
less than one-third of patients with CML survived for five years. The new medicine, clinical
trials show, boosted that survival rate to around 90 percent or more—and is now the
standard of care for that disease.
Also, knowledge from the development of one such weapon—even if it isn’t designed to
specifically attack malignant mesothelioma—can yield insights that will help in the battle
against asbestos-caused disease. Every day scientists are learning more about how to
attack specific tumors, how a tumor’s environment in the body can help or hinder its
growth, and what special tricks tumors use to thrive and spread. A multitude of research
studies are under way to translate that knowledge into action.
Meanwhile, the medical literature on mesothelioma reflects how individual miracles happen.
A report in January 2011 in the Journal of Medical Case Reports described a woman in her
40s who is alive and well seven years after diagnosis with peritoneal mesothelioma, a
cancer of the lining of the abdomen. Her physicians attribute her good fortune to the
contained nature of the disease, her successful surgery and chemotherapy, and specific
characteristics of her tumor tissue. Another case report, appearing just a month earlier in
the journal Diagnostic Pathology, describes a patient who developed pleural mesothelioma,
a cancer of the lining of the lungs, after asbestos exposure and was healthy 14 years after
symptoms appeared, and a dozen years after surgery and chemotherapy. And a report from
2007, appearing in the journal The Annals of Thoracic Surgery, recounts a surgical patient
whose pleural mesothelioma spontaneously regressed. The patient experienced just a single
recurrence six years into a 12-year follow-up period, and that tumor in the chest was
successfully removed.
In short, as oncologists and other experts will readily acknowledge, statistics reflect the
history of a group—not the future of an individual.
2. Taking a Shot at Mesothelioma
Researchers at Memorial Sloan-Kettering Cancer Center in New York City are recruiting
patients for a clinical trial to test a ―vaccine‖ under development for the mesothelioma
treatment.
Unlike many well known vaccines—such as a shot to protect against onset of illnesses such
as the flu or the mumps—this vaccine is intended to be given to people who already have
malignant pleural mesothelioma, a cancer of the lining of the lung. Very preliminary tests
have suggested that the experimental vaccine can mobilize a patient’s own immune system
to attack mesothelioma cells.
Specifically, the vaccine appears to target WT1, a type of protein that binds to a specific
part of the DNA code, affecting the transfer of genetic information and impacting how cells
function. WT1 is especially abundant in cells from many people’s mesothelioma tumors.
The preliminary tests, whose results were published in fall 2010 the journal Cancer
Immunology, Immunotherapy, found that the vaccine worked to mobilize two different
types of immune cells known as T cells, and those T cells were able to kill the cancer cells
with abundant WT1. Also, the vaccine was well tolerated, causing minimal problems with
side effects among test patients, the researchers noted.
Participants in the preliminary trial, which included both malignant mesothelioma patients
and those with non–small-cell lung cancer, received six doses of the vaccine, injected under
the skin, along with an immune-boosting substance. Injections were given at the start of
the study, and four, six, eight, 10 and 12 weeks later. People whose tumors responded
received additional injections once a month.
While only a handful of patients received the vaccine in this early trial, a majority of them
showed an immune response to the treatment, setting the stage for the current, Phase II
randomized clinical trial. The new trial is for adult patients who have had their pleural
mesothelioma tumors surgically resected and have received chemotherapy or radiation. Half
the participants will receive a series of shots over 10 weeks containing the WT1-targeted
vaccine, along with some general immune-boosting medicines, while the other half will
receive those general immune boosters alone. Neither the patients nor the researchers will
know who received which treatment.
The research team, which hopes to enroll 78 participants whose tumors test positive for the
WT1 protein, will evaluate whether or when their mesothelioma recurs for a period of one
year after the vaccine treatment is completed. The principal investigator conducting the
study is thoracic oncologist Dr. Lee Krug, director of the Mesothelioma Program at Memorial
Sloan-Kettering. Dr. Krug can be contacted at 212-639-8420 or 646-888-4201.
The identifier number for the new mesothelioma clinical trial is NCT01265433. Researchers
expect the trial to be completed in December 2014.
3. Study of New Medicine for Mesothelioma Treatment
The National Cancer Institute is sponsoring a clinical trial of a
new medicine in hopes that it will help mesothelioma
patients whose cancers have been unresponsive to
chemotherapy. The trial is being conducted at the National
Institutes of Health’s Clinical Center in Bethesda, Md., and is
led by Dr. Raffit Hassan.
The experimental medicine that is being tested – IMC-A12 –
is a human antibody. The trial is a Phase II study, meaning the medicine has already shown
promise in preclinical testing in the laboratory and has been tested in people to assess
safety and proper dosage. The current research will continue to investigate safety and
evaluate IMC-A12′s effectiveness against mesothelioma tumors.
The medicine, also called cixutumumab, is given intravenously in the trial once every 21
days to patients with pleural mesothelioma (cancer in the thin layer of tissue that surrounds
the lungs and lines the chest cavity) or peritoneal mesothelioma (cancer in the lining of the
abdomen). The study is open to adults whose tumors can’t be fully removed with surgery,
and whose cancer has not responded to chemotherapy with drugs known as platinum-based
agents, such as cisplatin, which is commonly used to treat mesothelioma. Patients might
also be admitted if they have refused previous chemotherapy as part of their mesothelioma
treatment.
Treatment will be ongoing unless patients develop severe side effects or their mesothelioma
progresses. The primary goal is to see whether mesothelioma tumors partially or completely
respond to the medicine.
The antibody works somewhat in the way that glue gums up the works of a lock and
prevents a key from opening a door. IMC-A12 (the ―glue‖) stops up certain receptors
(―locks‖) that sit on the surface of a mesothelioma cell. That way, a protein called Type I
insulin-like growth factor, or IGF-1R—the normal ―key‖ that would open the door to the
cancer’s growth and survival – no longer works. This particular type of ―lock‖ and ―key‖ is
also being studied in other cancers.
All participants in the IMC-A12 trial must have acceptable kidney and liver function as well
as the adequate ability to form blood cells, and must not have had any major surgery,
radiation treatment, chemotherapy or biologic therapy within 28 days of the start of the
new mesothelioma treatment. Potential participants will be given a complete physical exam
to assess their mesothelioma and overall health.
Patients must cover their own travel expenses to be screened for possible enrollment in the
trial, but those selected to participate will receive payment for out-of-town transportation
costs for study treatment and follow-up. All medical care related to the trial will be provided
for free at the NIH Clinical Center, but patients should maintain any current health care
coverage to pay for other medical expenses.
Additional information about the mesothelioma study and its requirements can be obtained
from the cancer institute’s referral office, at 1-888-NCI-1937. The study’s identifying tag at
ClinicalTrials.gov is NCT01160458.
4. Mesothelioma and Gemcitabine
New research from Europe suggests that a drug known as gemcitabine, given along with one that
is now commonly used for mesothelioma, might someday serve as another weapon in doctors’
arsenals against the cancer.
Gemcitabine (marketed as Gemzar) is a chemotherapy drug currently in use to treat lung, breast,
pancreatic and ovarian cancers. In the recent, Phase II study—designed to test whether the drug
is effective and to measure side effects and other risks—investigators in Slovenia gave patients
with malignant pleural mesothelioma a prolonged, low-dose infusion of gemcitabine in
combination with cisplatin (marketed as Platinol).
The researchers decided to test this course of therapy against malignant pleural mesothelioma—a
cancer in a layer of specialized cells, called mesothelial cells, that line the chest and are adjacent
to the lungs—after noting that the treatment appeared to be effective in advanced cases of the
most common type of lung cancer, non–small-cell lung cancer.
Patients in the mesothelioma study were eligible if they had not previously received any
chemotherapy, and other than the mesothelioma, were in fair to good health with normal liver
and kidney function. The treatment entailed six three-week cycles of therapy. For the first four
cycles, patients received six-hour infusions of gemcitabine on the first and eighth days, plus
cisplatin on the second day; the last two cycles included the gemcitabine but not the cisplatin. A
total of 78 patients—58 men and 20 women, ages 33 to 82 years old—participated. More than 70
percent of the patients had mesothelioma tumors of the most common subtype, known as
epitheloid, a categorization based on certain characteristics of the cancer cells.
Four of the patients, or 5 percent, showed a complete response—meaning their cancer was
undetectable—after the therapy. Thirty-five had a partial response—meaning the size of their
tumors was reduced substantially. Another 35 patients had tumors that either responded
minimally or remained stable, while only four patients experienced tumor progression during the
treatment.
Sixty-seven percent of the mesothelioma patients survived one year after therapy; almost 33
percent survived two years, and about 20 percent survived three years. Patients who had
epitheloid tumors were more likely to survive longer without their tumor progressing, and to
survive longer overall, compared with patients who had other tumor subtypes.
Most of the patients experienced an improvement in mesothelioma symptoms, and a quality of
life that either remained the same or improved, the researchers reported. Notable side effects
included neutropenia (a shortage in a type of white blood cells, which can impair the immune
system), anemia (a shortage of red blood cells, which can cause fatigue) and hair loss, as well as
thrombocytosis (an excess of blood platelets, which cause clotting). Because the therapy
appeared to slow down the mesothelioma’s progress and didn’t prove to be too toxic, the
scientists advised that this mesothelioma treatment approach warranted further research.
5. Photodynamic therapy for pleural mesothelioma
A combination therapy might hold promise for
extending the lives and preserving more lung
function of patients with malignant pleural
mesothelioma, a cancer of the lining inside the
chest.
Patients in mesothelioma treatment often undergo
an extensive surgery known as a modified
extrapleural pneumonectomy, which involves
removal of the lung and surrounding tissue and is
usually accompanied by radiation of the whole
chest area. But the new combination approach for
mesothelioma patients adds a treatment called
photodynamic therapy to a more conservative,
lung-sparing surgery called a pleurectomy.
Photodynamic therapy is a light-based treatment that is designed to eliminate any microscopic bits of
residual cancer that surgeons are unable to remove. The therapy, which penetrates just a few
millimeters into tissue, has three components that are administered: a nontoxic compound that
sensitizes cancer cells to light; then oxygen; then specially tailored light. While the therapy is federally
approved for treatment of several cancers, it remains experimental for malignant pleural
mesothelioma.
Researchers at the University of Pennsylvania in Philadelphia set out to determine whether the lung-
sparing surgery could be used instead of an extrapleural pneumonectomy, and whether the use of
photodynamic therapy would extend patients’ survival time, compared with typical survival times in
mesothelioma patients.
Nine women and 19 men with malignant pleural mesothelioma, ranging in age from 27 to 81,
participated in the Phase II study from 2004 to 2008. Half received the more extensive surgery along
with photodynamic therapy, while the other half had the lung-sparing surgery along with the light-
based therapy.
Twelve patients in each group had stage III/IV mesothelioma—and researchers noted that many of
the research subjects, due to the advanced stage of their mesothelioma or to their advanced age,
would not be candidates for surgical treatment. In all, 22 patients also had chemotherapy. The two
groups were comprised of mesothelioma patients with similar demographic traits such as age, sex and
disease characteristics.
Among the patients who had the more extensive surgery and photodynamic therapy, the median
overall survival—the point in time after treatment was completed at which half the patients were still
alive—was 8.4 months. For the patients receiving the lung-sparing surgery plus the light therapy, that
median point had not been reached yet, after more than two years of follow-up.
The surgeon who performed the procedures in the study, Dr. Joseph Friedberg of the Penn
Mesothelioma and Pleural Program, said researchers had hoped that preservation of patients’ lungs
would improve their quality of life, and that the extended survival time of those patients was a
complete surprise. The scientists are continuing to investigate exactly how the photodynamic therapy
might be helping to fight mesothelioma—possibly by creating a ―vaccine‖ effect with residual disease
that sparks the immune system to fight any remaining cancer. Or, the photodynamic therapy might
have made any residual cancer more vulnerable to other follow-up treatments.
6. SIDE EFFECTS OF CHEMOTHERAPY ON MESOTHELIOMA PATIENTS
While doctors might choose from an assortment of
available medicines to care for
malignant mesothelioma patients, a combination
treatment with two chemotherapy drugs—pemetrexed
disodium (marketed as Alimta) and cisplatin (marketed
as Platinol)—is a mainstay. The two drugs are typically
used in patients when surgery is not an option.
Pemetrexed received approval from the federal Food and
Drug Administration (FDA) in 2004 for the treatment of
malignant pleural mesothelioma, a cancer of the chest
cavity lining, after a randomized clinical trial showed that
the drug, given with cisplatin, extended patients’ average
survival time longer than cisplatin alone. As the first drug
shown to be effective against pleural mesothelioma,
pemetrexed received priority review from the FDA.
As with most chemotherapy treatments, mesothelioma patients are vulnerable to experiencing side
effects from the combination of pemextrexed and cisplatin. In more than half the patients in the
clinical trial, the treatment suppressed bone marrow function, which might lead to low counts of white
blood cells, the body’s infection fighters. It’s important that mesothelioma patients on pemetrexed and
cisplatin tell their doctors immediately about any signs of infection, such as fever or chills or mouth
ulcers. Vitamin B-12 and folic acid are administered with pemetrexed to reduce the risk of a low white
cell count, as well as the likelihood of other side effects.
Cisplatin and pemetrexed also lowered red blood cell counts in about one-quarter of the mesothelioma
patients in the clinical trial. This condition, known as anemia, can cause fatigue. Medicines are
available to treat both low white and low red blood cell counts. Also, research has shown that
moderate exercise can help reduce cancer patients’ fatigue, and perhaps lessen pain.
Mesothelioma patients on pemetrexed could also experience a drop in their platelet count. Platelets
help the blood to clot, and patients with reduced levels of platelets should report any signs of
bleeding. These patients also might be asked to take precautions to avoid even minor injuries that
might cause bleeding, such as using a soft toothbrush to prevent gum bleeding.
Nausea and vomiting are very common side effects of the pemetrexed-cisplatin combination;
fortunately, effective anti-nausea medicines can be prescribed. Patients should promptly tell their
doctors about those symptoms—as well as rash, diarrhea, constipation, sore or gritty eyes and other
health concerns. It’s important that mesothelioma patients keep their health care teams fully informed
of side effects and avoid choosing over-the-counter treatments without medical consultation.
To learn more about the symptoms, diagnosis, treatment options, and resources for dealing with the
lung cancer or mesothelioma, call at 1.866.855.1229 or visit www.mesotheliomanews.com .
And if you, a family member or friend have been diagnosed with mesothelioma and believe it has been
caused by asbestos exposure, visit http://baronandbudd.com. Baron & Budd has been protecting the
rights of people with mesothelioma for nearly 30 years. Baron & Budd can help you seek the
compensation you deserve.
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