Author: Nancy Meredith
Mesothelioma Patients Eye Combination Therapy Given FDA Priority Review for Bringing “Significant Survival Benefit” To Lung Cancer Patients
In October 2016, MesotheliomaHelp reported the U.S. Food and Drug Administration approved the immunotherapy drug atezolizumab (TECENTRIQ, Genentech Oncology) for the treatment of patients with metastatic non-small cell lung cancer (NSCLC) whose disease progressed after platinum-based chemotherapy. Now, Genentech reports the FDA has granted priority review for Tecentriq when used in combination with bevacizumab (Avastin), paclitaxel and carboplatin (chemotherapy), for lung cancer patients.
The status was given based on results from the Phase III IMpower150 study, according to the May 6 press release from Genentech announcing the approval. The trial was established to evaluate the safety and efficacy of Tecentriq with the triple drug combination compared with patients receiving the triplet without Tecentriq. Tecentriq is designed to target PD-L1 expressed on tumor cells and tumor-infiltrating immune cells and to enable the activation of T cells, according to the company.
“Our Phase III results showed TECENTRIQ in combination with Avastin, paclitaxel and carboplatin has the potential to provide a significant survival benefit in the initial treatment of metastatic non-squamous non-small cell lung cancer,” said Sandra Horning, M.D., chief medical officer and head of Global Product Development. “We are working closely with the FDA to bring this treatment regimen to people with this type of lung cancer as soon as possible.”
Lung cancer is by far the leading cause of cancer death among both men and women in the U.S., according to the American Cancer Society. The ACS estimates about 234,030 new cases of lung cancer will be diagnosed in 2018, with approximately 154,050 Americans dying from the cancer. Nearly 3,000 Americans are diagnosed with mesothelioma, with close to the same number losing their lives to it each year.
Pleural mesothelioma is an asbestos-caused cancer affecting the lining of the lungs. Although there are clinical differences between lung cancer and mesothelioma, the treatment protocol for the two cancers are similar. Mesothelioma is a terminal cancer with limited treatment options. Any new breakthrough or approval in the treatment of NSCLC is considered a win for mesothelioma patients as well.
A Priority Review designation will direct overall attention and resources to the evaluation of applications for drugs that, if approved, would be significant improvements in the safety or effectiveness of the treatment, diagnosis, or prevention of serious conditions when compared to standard applications, according to the FDA.
A Priority Review designation means FDA’s goal is to take action on an application within 6 months. Genentech reports the FDA is expected to make a decision on approval by September 5, 2018.
Find out more about the IMpower150 clinical trial at ClinicalTrials.gov.
- American Cancer Society
Chemicals Identified As Potential Targets for Lung Cancer May One Day Be Focus for Personalized Mesothelioma Treatments
After five years spent testing and retesting over 200,000 different compounds as candidates to be used in the treatment of lung cancer, researchers narrowed the list down to 170 chemicals. Now, the team plans to delve deeper into the mechanisms of the compounds and to assess the effectiveness against other types of cancers. Potentially, mesothelioma and other aggressive cancer patients will benefit from the new discovery.
The team of researchers from University of Texas Southwestern Medical Center, using the Center’s “unique lung cancer cell library,” set out to identify therapeutic triads, according to an April 19 press release. The search required testing against a trifecta of criteria including finding chemicals that kill cancer cells, biomarkers that predict who would respond, and the therapeutic targets on which those active chemicals work.
The 170 chemicals were tested against 100 lung cancer lines to confirm they all met the three sets of criteria. The resulting chemicals are called the Precision Oncology Probe Set, or POPS. This testing approach is considered unusual for cancer research with the team looking at drugs first, then cancers.
“Almost all cancer research is gene-first, or target-first. We began with the potential drugs,” said Dr. Michael Roth, Professor of Biochemistry and a member of the Simmons Cancer Center.
The researchers report that these findings are “a significant step forward toward personalizing cancer care.” They report that for most of the compounds they identified a biomarker that can lead to the development of precision medicine. This means patients with those biomarkers can receive individualized care.
Personalized care targeted to the unique characteristics, such as the biomarkers, of a mesothelioma patient increases the chance of success, and can extend their survival and improve their quality of life. For most mesothelioma patients, life expectancy is less than a year after diagnosis and they often struggle with daily living tasks. There is no cure, and there are limited treatments for the asbestos-caused cancer.
UT Southwestern researchers are known for their innovative approach to cancer research with their findings bringing hope to the mesothelioma community. MesotheliomaHelp has reported on UT’s research into chili peppers in combating cancer and into a new target in fighting the KRAS gene in cancer. They have also conducted mesothelioma clinical trials.
UT Southwestern Medical Center is one of the few institutions in the country with a treatment and research program dedicated to mesothelioma, according to its website. To find out more about UT Southwestern’s research and treatment for mesothelioma, visit the Mesothelioma program’s website.
Read the full study in the March 28 issue of the journal Cell.
- University of Texas Southwestern Medical Center
- Mesothelioma program’s website
- UT Southwestern Medical Center
Anti-cancer drugs known as kinase inhibitors have often been used in the treatment of pleural mesothelioma and many other cancers. The drugs attack the protein kinases in an effort to prevent cell division and to kill the cancerous cells. Now, researchers report they have found that an investigative drug can effectively shrink tumors in patients with lung cancer and other difficult to treat cancers with a specific kinase. Pleural mesothelioma patients could benefit as well.
According to researchers from The University of Texas MD Anderson Cancer Center, in the first-in-human study of the investigational, oral drug BLU-667, “the drug appears to be promising” in cancers caused by an alteration in the receptor tyrosine kinase known as RET, or rearranged during transfection. The drug is “a highly potent and selective RET inhibitor” shown to have limited toxicity in the patients.
“Tumor reductions and durable responses were observed in most patients, especially those patients whose cancer progressed with chemotherapy and multi-kinase inhibitors,” said Vivek Subbiah, M.D., Assistant professor of Investigational Cancer Therapeutics at MD Anderson Cancer Center, in an April 15 press release.
In the study of 43 patients with advanced tumors not eligible for surgery, 26 patients with thyroid cancer, 15 with non-small cell lung cancer, and two with other RET-driven cancers, the overall response rate was 37 percent for RET-driven cancers, with responses of 45 percent for non-small cell lung cancer and 32 percent for thyroid.
“Overall, the data show the precision targeted therapy with next-generation kinase inhibitors can have a powerful impact for patients with RET-driven cancers,” said Dr. Subbiah.
Kinases function as drivers for numerous types of cancer, including mesothelioma. Kinases are involved in the gradual transformation of normal tissue in the lining of the lung into malignant pleural mesothelioma after exposure to asbestos. Various kinase inhibitors have been used to treat mesothelioma and other cancers, but according to Dr. Subbiah, these “earlier generations of multiple kinase inhibitors” have limited success and come with significant side effects.”
Although researchers have made progress in recent years, identifying an effective treatment modality for the fatal mesothelioma remains elusive. Taking a personalized approach to the treatment of mesothelioma by targeting a patient’s unique genetic characteristics, such as the RET biomarker, offers the most effective treatment options.
“By offering a highly selective medicine tailored for this oncogenic driver, we hope this new therapy will enable patients to benefit from the recent advances in genomic profiling that have revolutionized treatment options for patients with kinase-driven diseases.”
Find the results of the study in the April 15 issue of Cancer Discovery.
For years, researchers have struggled to find the reason mesothelioma and other cancers aggressively grow and spread throughout the body. Primarily, the focus has been on the spread of cancer cells through the bloodstream. Now, researchers report they have discovered a new organ that could be responsible for unbridled cancer growth.
In a recent discovery, researchers from New York University’s School of Medicine report they found a new organ that sits one layer below the skin. The mesh-like interstitium, as it has been named, is a layer of interstitial tissue filled with and surrounded by interstitial fluid. Although they have known about the tissue and fluid, the way the tissue had been examined in the past, with the fluid removed, it was seen as just another piece of tissue.
According to a March 27 article in the CNN, when the researchers kept the tissue alive and examined it more closely, they found that it has a unitary structure with compartments filled with fluids. The researchers surmised some of the fluid is lymph fluid, of the lymphatic system that supports immunity, and flows through the body through these interconnected compartments. The flow of fluids can also spread diseases, including cancer.
Because the interstitium has a single structure and a single function, Neil Theise, a professor at NYU’s School of Medicine and author on the paper, says it meets the criterium to be considered an organ. The interstitium is throughout the body, like the skin, but he says, it is even larger than the skin.
Thiese believes the interstitium could change the way doctors think about cancer and other diseases. “It’s been known that when cancer invades this layer, either in the skin or in the viscera, that’s when it first becomes able to spread outside the organ of where it arose,” said Theise.
“This discovery will open up new research pathways for inflammation and cancer progression,” added Dr. Petros Constantinos Benias, co-lead author of the study, a member of the Feinstein Institute and an assistant professor at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health.
Mesothelioma is the signature cancer of asbestos caused by inflammation from inhaling the microscopic fibers. The cancer can spread rapidly, and treatments are focused on trying to halt metastasis. This new understanding of how the cancer may travel through the interstitium could lead to a new approach for halting cancer growth.
Much more research still needs to be conducted, but the team suggests that whereas currently blood and tissue samples are used as a diagnostic tool, interstitial fluids may be effective.
“We are optimistic that with what we learned, we’ll soon be able to study and target the interstitial space for diagnosis of disease and perhaps for novel personalized treatments,” said Dr. Benias.
Find the study in the March 27 issue of Scientific Reports.
Author: Brianne Hoglin
It’s nearly impossible to forget the moments in life when you receive news that forever places a mark on your personal story. When I was a freshman in college, hundreds of miles away from my family and home I was studying one evening when I got a phone call from my mom, who offered me the heart-wrenching news that my grandfather had finally lost his second battle with lung cancer and passed away moments earlier. That week had been especially hard on him, concluding a difficult summer where a second fight with lung cancer proved much more furious than the first. As his family it was a painful season of life for us as well to watch the exponential increase in the cruelty of his symptoms, the decline in quality of living, and the steady damage to his will to continue fighting. At reception of the news I remember feebly falling to the ground in the hallway and just crying uncontrollably, with no relief or comfort coming from the teachers and peers that tried to console me. At that moment I remember feeling like the room was spinning and at the root of it all I just felt so helpless.
That feeling of helplessness is often a huge weight that hangs on the patients dealing with any type of cancer as well as their families. Mesothelioma is one such cancer that affects thousands of individuals every year, and which has seen an increase in diagnosed cases within the span of recent years . With the only known cause of mesothelioma being exposure to asbestos, there is an additional burden placed on the sufferers of this disease and their families with the consideration of the neglect for prevention, and the absence of sufficient information provided to them regarding the risk presented by asbestos exposure. Many workers in the United States in laborer occupations such as emergency responders, industrial manufacturers and builders, and factory workers have had unreasonably high exposure rates to asbestos and in response have unfortunately seen high incidence of mesothelioma symptoms and diagnoses . While now there is much more information available and more precautions taken, by the nature of the development of the disease, most of the affected individuals most likely suffered exposure 10-40 years ago . And even though there are treatment options available, the reality of mesothelioma presents a discouraging prognosis, especially depending on the stage of cancer which the patient is facing when the initial diagnosis is made.
Since I have seen firsthand the effects and stress put onto a family by the cruel outcome of watching a loved one endure the symptoms, both physical and psychological, caused by the terrible diagnosis of a lung specific cancer I am rigorously inspired to make a difference in in the lives of those fighting this overwhelming battle. As a result, the desire to help alleviate as much as that feeling of complete helplessness as possible is a constant driving factor which inspires me every day to continue to pursue a future career in medicine. My own personal experience along with the testimonies of people who have been diagnosed with mesothelioma and other cancers lights an indestructible fire within me. I passionately anticipate the opportunity to someday have the skill and facility to provide some relief to families and patients impacted by a threatening diagnosis. I hope to do this by making adequate information and appropriate treatments available to them. This passion further drives me to tackle the high challenge of medical school and the work required to become a competent medical doctor. When it comes down to the foundation of things, simply put, I want to offer the best care possible to the individuals, focusing on the patient and the opportunity for a beneficial relationship rather than only the disease.
However, treatment and support for patients and their families is only part of the battle when it comes to this disease. While mesothelioma has limited treatments available, there is boundless occasion for prevention. As a community of citizens we should consider it a priority to not only educate people of the dangers and risks their occupation may afford, but to also make it accessible and required for adequate preventative measures to be taken. While huge strides have been made to make asbestos exposure much less likely, there is still high risk to be payed attention to. Simply by spreading awareness and taking responsibility onto ourselves, we have the potential to make a huge impact. Especially with the network that current social media provides, playing our individual roles is literally at our fingertips.
An online community can not only help spread awareness and aid prevention efforts, but it can also be a valuable resource to those suffering from the effects of mesothelioma and other cancers. With online support groups and advice, there is a nearly unlimited possibility for patients and their families to avoid completely the feeling of aloneness. I would encourage anyone faced with cancer to not be ashamed or timid in seeking out support, but rather to take advantage of every resource offered to them. And along with receiving support, sharing personal stories and experiences could benefit a whole other community of people. After all, as people we need community and are much stronger together.
I would hope that everyone, regardless of their own personal experience with mesothelioma or any cancer, would take it upon themselves to help build a community of support and awareness to combat the devastating nature of the disease and help make a lasting difference in the lives of the thousands affected. This should be done both in honor of those who have fought, or are fighting mesothelioma, as well as in celebration of the lives that can be changed for the better by preventing the disease from ever surfacing. Because cancer is something that not only affects the person diagnosed, but like Terri Clark said in her quote regarding her mother’s battle with cancer, it spreads to affect everyone involved.
 “Mesothelioma Cancer: Prevalence, Occurrence, Causes and Legal View.” Carcinomasymptoms.com. 2003-2015. Web. 2 Sept. 2015.
 “Mesothelioma Prognosis & Survival Rate Information.” MesotheliomaHelp.org. Belluck & Fox, LLP, 11 Mar. 2014. Web. 2 Sept. 2015.
 Clark, Terri. Lifehack Quotes. N.p., n.d. Web. 2 Sept. 2015.
I am a premed student pursuing a major in Molecular Biology as well as a minor in Chemistry at Lipscomb University in Nashville, Tennessee. Outside of academics I am a part of the NCAA Division 1 Women’s Track and Cross Country programs here at Lipscomb and a mentor for the IDEAL Program for students with disabilities. Since my start of participation in the essay competition I have talked with some people about the facts I have learned, and shared my thoughts on what we should do to raise awareness as a community. My participation in this experience has also raised thoughts to me about how my career as a doctor can be used to help raise awareness, possibly by me becoming a specialist in oncology.
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