Month: February 2012
Enlisting the Body’s Immune System to Fight Mesothelioma and Asbestos Disease
Mesothelioma, a cancer of the lining of the lung and abdomen, suppresses the normal immune system response designed to ward off disease. Scientists have been trying to understand the mechanics of the immune suppression process to develop more effective therapies for mesothelioma, an aggressive form of cancer.
One promising treatment is immunotherapy that enlists the body’s natural defense system to shrink cancerous tumors. A number of immunotherapies are currently being tested in clinical trials. Mesothelioma is among the cancers that appear to be responsive to immunotherapy, researchers say. But the failure of immunotherapies to stop the growth of malignant mesothelioma tumors suggests that the immune suppression process is complex and involves multiple targets.
In an article published in the journal Immunology and Cell Biology, researchers at Harvard University investigate the roles of three factors affecting the immune response: regulatory T cells, intratumoural transforming growth factor (TGF)-â and the protein cytotoxic T lymphocyte-associated antigen-4, which plays a regulatory role in the immune system.
The researchers say that immunotherapy treatments targeting multiple regulators simultaneously appear to be more effective than focusing on one regulator protein that is suppressing immune response. They report that a triple treatment involving all three immune system factors led to long-term shrinkage of tumors and residual resistance to cancer cells if tumors reappeared.
“These data suggest that clinical application of immunotherapies against tumors may be improved by simultaneously targeting multiple mechanisms of immune suppression,” said lead investigator Haydn T. Kissick in a summary of the research.
Mesothelioma is caused by exposure to asbestos fibers. When a person breathes asbestos dust, the microscopic asbestos fibers can penetrate deep in the lungs and cause inflammation and eventually disease.
Approximately 2,500 to 3,000 people a year in the United States receive a diagnosis of malignant mesothelioma. Many victims of mesothelioma are older workers, retired workers and veterans who were exposed to asbestos decades ago in a workplace. The symptoms of mesothelioma typically take 20 years to 40 years to appear, but the disease is aggressive once it appears.
Asbestos Trust Fund Established for Navy Veterans With Mesothelioma and Other Asbestos-Related Diseases
Mesothelioma, a cancer caused by exposure to asbestos, affects nearly 3,000 Americans each year. However, over one-third of the victims are military veterans. Due to the extended latency period of the disease some veterans exposed to asbestos between the 1950s and 1970s are just now exhibiting symptoms, and are dealing with their mounting medical bills. Financial relief will soon be available for some of these veterans through the formation of a fund designated for compensation to Navy veterans who were harmed by asbestos disease.
Under a Chapter 11 bankruptcy reorganization plan, Leslie Controls, Inc, a manufacturer that supplied asbestos-containing gaskets and valves to the U.S. Navy from the 1940s until the 1980s, has established an “Asbestos PI Trust” available to Navy veterans.
According to the plan, Leslie’s parent company, CIRCOR, made a contribution of $74 million to the trust on behalf of itself and other CIRCOR-related parties. Leslie contributed $1 million with a yearly 5% interest payment.
The plan includes a pay level based on the medical issue affecting the claimant. Currently, a “powerhouse and below-deck Naval station claim” of mesothelioma will be awarded $100,000 with a maximum value of $350,000. Any “construction and maintenance claims” for mesothelioma will receive $25,000 with a maximum value of $125,000. Amounts are also established for lung cancer and asbestosis.
Asbestos was used as insulation around steam pipes and valves and led to the exposure of hundreds of thousands of Navy veterans to the cancer-causing mineral fibers over the decades. Asbestos is a known carcinogen that has been linked to respiratory diseases, including asbestosis, lung cancer and mesothelioma. The symptoms of mesothelioma can be managed through chemotherapy and radiation. There is no cure for the disease.
Claims may be filed with the trust starting in March 2012. All claims are subject to review and approval by the trust committee.
Mesothelioma Patients May Benefit from Blood Thinner for Reducing Risk of Developing Blood Clots
In September, Duke researchers warned cancer patients of the potential of developing blood clots, or venous thromboembolism (VTE), during treatment, and up to one year after receiving chemotherapy. Now, the SAVE-ONCO study, funded by Sanofi, reports that in patients who were treated with an experimental form of heparin the risk of developing a blood clot was reduced by 65%. For mesothelioma patients facing other life-threatening complications, the addition of a blood thinner, such as heparin, to their treatment regimen may make a difference in their prognosis.
Low-molecular-weight heparin (LMWH) is often used during surgical procedures to limit the risk of VTE. However, many doctors are hesitant to use heparin during other forms of treatment for fear that the risk of bleeding complications outweighs the risk of a patient having a VTE.
In an editorial in the New England Journal of Medicine, Drs. Elie Akl and Holger Schünemann of McMaster University discussed the potential benefits of adding ultra-low-molecular-weight heparin semuloparin during cancer treatment. The doctors referred to the results of the SAVE-ONCO study where patients receiving chemotherapy were also given a preventive dose of the medicine once daily for just over three months. The study demonstrated the benefits of the drug “without increase in major bleeding.”
The two doctors reported that the SAVE-ONCO study, taken together with prior similar studies, confirm their conclusion of “a likely small survival benefit” from the use of the drug.
The pair of doctors estimated “if 1,000 patients with cancer were to use a prophylactic dose of LMWH, approximately 30 would avert death, 20 would avert a clotting complication and one would suffer a major bleeding episode over a 12-month period.”
They added that daily injections of the LMWH could avert hospitalizations, and potentially, increase survival.
Duke researchers reported in their study that the average increase in costs associated with a VTE was $35,000 over patients without blood clots. Some doctors estimate that mesothelioma treatment already costs anywhere from $150,000 to $1 million. The added expense would place an undue, additional financial burden on the patients.
Akl and Schünemann added that patients looking for survival from their cancer will be faced with “some uncertainty” with the benefit from LMWH. They also added that more research is needed and “they are planning a sophisticated analysis of the published trials.”
Mesothelioma is a unique cancer affecting the lining of the lungs, and other organs, due to past exposure to asbestos. Treatment varies for the disease, depending on the stage of the cancer, but often involves surgery, chemotherapy and radiation. 3,000 Americans are diagnosed with the disease each year.
Symposium To Focus on Lung-Sparing Therapies for Malignant Mesothelioma Patients
Medical doctors and researchers will gather on May 12 in Santa Monica, California for the 2nd Annual International Symposium on Lung-Sparing Therapies for Malignant Pleural Mesothelioma. Mesothelioma is an aggressive cancer of the lining of the lung and abdominal cavity caused by asbestos exposure.
Approximately, 2,500 to 3,000 people are diagnosed with malignant mesothelioma in the United States each year. The incidence of mesothelioma has increased in recent decades.
The symposium promotes less invasive alternatives to the radical surgery that involves extensive removal of tissue and organs in mesothelioma patients and prolonged recoveries. Dr. Robert Cameron, director of the UCLA Mesothelioma Comprehensive Research Program and an advocate of lung sparing therapies, will lead the symposium.
The radical surgery attempted on some mesothelioma patients is known as extrapleural pneumonectomy. Also known as EPP, extrapleural pneumonectomy is a procedure that involves removal of a lung, the lining of the lung, the diaphragm and the lining around the heart.
Participants at the first symposium last year reviewed the Mesothelioma and Radical Surgery (MARS) trail conducted in Great Britain from 2006 to 2009. The U.K. Mesothelioma and Radical Surgery trial tracked 50 patients—24 who underwent extrapleural pneumonectomy and 26 mesothelioma patients who did not undergo radical surgery. According to the results, 52 percent of the mesothelioma patients who underwent radical surgery lived 12 months, compared to 73 percent of the patients who had treatment that did not involve removal of a lung.
Participants concluded that the study offered no evidence that extrapleural pneumonectomy offered an advantage to patients over less invasive surgery. They said mesothelioma patients should no longer be subjected to debilitating lung-removing surgery.
The symposium is part of an ongoing debate within the medical community about mesothelioma treatment options and the value of radical surgery for mesothelioma patients. Some physicians advocate highly invasive surgeries for mesothelioma patients with less advanced cancer who are healthy enough to withstand the operation. Other doctors say that lung sparing pleurectomy/decortication procedures are effective and less debilitating.
The distinguished faculty will include experts from Houston, San Francisco, New York and as far away as South Africa.
“This symposium brings the best scientific and medical minds together to advance the treatment of mesothelioma,” Dr. Cameron said in a prepared statement. “Research and practice over the past several years have continued to evolve, working to improve cancer outcomes without unnecessarily sacrificing the affected lung. Clearly, it is best for the patient to treat mesothelioma as a chronic illness while preserving the function of both lungs.”
Many workers and veterans who develop mesothelioma were exposed to asbestos dust on the job, though disease symptoms typically take 20 years to 40 years to be diagnosed.
For more information about mesothelioma, click here.
FDA Addresses Drug Shortages Impacting Mesothelioma Patients and Young Cancer Patients
In November, President Obama issued an executive order to address the drug shortage that has affected mesothelioma and other cancer patients. Now, the EPA is taking action to bring relief to some patients that have not been able to receive critical treatments for their cancers due to the lack of two key drugs, doxorubicin and methotrexate. Methotrexate is used to treat childhood leukemia. Doxorubicin is one of many platinum-based drugs used to fight mesothelioma, as well as ovarian cancer and multiple myeloma.
The FDA announced Tuesday that it will allow temporary imports of Lipodox as a replacement for doxorubicin. The FDA anticipates the influx of the drug will “fully meet patient needs in the coming weeks.” The FDA noted that temporary importation of unapproved foreign drugs is only considered in rare cases when the shortage cannot be met with existing FDA-approved drugs.
The Agency has approved a new manufacturer to supply methotrexate that is “expected to further bolster supply and help avert shortage of this lifesaving medicine.”
“A drug shortage can be a frightening prospect for patients and President Obama made it clear that preventing these shortages from happening is a top priority of his administration,” said FDA Commissioner Margaret A. Hamburg, M.D. “Through the collaborative work of FDA, industry, and other stakeholders, patients and families waiting for these products or anxious about their availability should now be able to get the medication they need.”
The FDA also reiterated the requirements for both mandatory and voluntary notifications from drug manufacturers to provide quicker notice of impending shortages and to improve communication with the government agency in order to address supply issues early.
Mesothelioma, a rare, asbestos-caused cancer is typically treated with chemotherapy drugs. The drugs are usually given in combinations of two or more during treatment, with the preferred combination being gemcitabine and cisplatin for mesothelioma.
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