Mesothelioma Advocacy Isn’t A One-Time Gig

Sometimes, I sit and wonder how many different ways I can discuss the importance of advocacy. How many ways can I write about how critical it is to spread awareness of mesothelioma and the dangers of asbestos? Should I just sit back and think that I’ve done enough and let my past words and actions speak for themselves?

The answer is simple… absolutely not! Every single day, someone new is introduced into the mesothelioma community, whether it be as a patient, caregiver, researcher, friend, or concerned citizen. We cannot stop fighting just because we think that daily chatter may already be saturated with concerns.

Advocacy isn’t just for those currently clashing with this horrific disease. It is for those who have lost their lives fighting. It is for the future generations who will hopefully know nothing about mesothelioma, because it has been eradicated forever. It is for everyone.

Even if you think that an effort that you deem as small can’t impact someone, think again! A simple article posted on social media, a comment to an acquaintance, anything can help in this ongoing fight. It is important to keep this battle going and fight until the end, until mesothelioma is only a memory in the eyes of everyone in the world.

Could Creepy Crawlers Someday Be Useful in Mesothelioma Care?

While MesotheliomaHelp has reported numerous times about research that looks to nature, mostly in fruits and vegetables, to bring new treatments to mesothelioma patients, researchers are now looking at shiver-inducing worms and slugs for patient care. In two separate studies, researchers looked to the slimy critters for inspiration in developing medical products that can aid in patient care.

Slug Mucus Inspires Medical Glue

Researchers from Harvard University report that they developed a glue inspired by the slime from slugs that can be useful in surgery, according to July 28 article from the BBC. Trying to find a tissue adhesive, or glue, that can be used instead of stitches or staples on patients, researchers from Harvard University turned to the “Dusky Arion” slug, whose body is covered in a sticky mucus, as guidance.

The challenge of developing an adhesive product that can stick to damp surfaces, such as organs and skin, is flexible enough to move freely and is less damaging to the healthy tissues, had stymied researchers until they discovered the characteristics of slug mucus could be copied.

“We engineered our material to take on the key features of slug mucus and the result is really positive,” said Dr. Jianyu Li, Wyss Technology Development Fellow, Harvard University. “I’m really amazed by this system. We have solved a big challenge and opened up big opportunities in the medical setting.”

The “bio-glue” is incredibly strong, moves with the body and sticks to wet surfaces. According to the researchers the glue is not toxic and is three times stronger than current options, with adhesion occurring within minutes. They indicate that this family of adhesives could be useful for tissue adhesives, wound dressings, and tissue repair.

This finding can be especially useful for mesothelioma patients who undergo surgery as a form of treatment. One option is the extrapleural pneumonectomy, a surgery to remove a diseased lung and its surrounding layer of tissue known as the pleura. The alternative to EPP is the lung-sparing radical pleurectomy/decortication surgery, a complicated surgery that involves stripping away the diseased membrane lining the lung but keeping the lung intact. Both surgeries require extensive incisions that are typically sewn back up – bio glue might be a great alternative.

Wyss Founding Director Donald Ingber, who is also the Judah Folkman Professor of Vascular Biology at Harvard Medical School and the Vascular Biology Program at Boston Children’s Hospital, as well as a Professor of Bioengineering at Harvard SEAS, said of the bio glue:

“Nature has frequently already found elegant solutions to common problems; it’s a matter of knowing where to look and recognizing a good idea when you see one. We are excited to see how this technology, inspired by a humble slug, might develop into a new technology for surgical repair and wound healing.”

The glue has proven effective in the lab on mice and on a pig’s heart, but significantly more research is required.

Read about the Harvard discovery in the July 28 issue of the journal Science.

Worm Could Be Universal Blood Donor

In another study, researchers from France found that the lugworm, a marine worm that burrows in the sand at low tide, has an “extraordinary ability to load up with life-giving oxygen” which may lead to a blood substitute that could save lives.

Researchers from Aquastream, a fish-farming facility on the Brittany coastline, and Hemarina, a French biotechnology company centered on the development of universal marine oxygen carriers, have partnered in this unique venture to find a way to harness the blood from the lugworm. This is the first collaboration into the medical use of lugworms. The companies must find a way to grow and harvest the worms, as well as finding a way to harvest the blood.

“The haemoglobin of the lugworm can transport 40 times more oxygen from the lungs to tissues than human haemoglobin,” says Gregory Raymond, a biologist at Aquastream, in a July 31 article on MedicalXpress. “It also has the advantage of being compatible with all blood types.”

While Aquastream focuses on bringing a “sustainable supply of the worms” to market, so far they can produce 1.3 million lugworms a year, Hemarina researchers are focusing on ways to extract the drops of hemaglobin from each worm.

“There is nowhere else in France or the world that has the capacity to produce lugworms in a controlled environment to ensure a supply of their haemoglobin,” said Aquastream director Nathalie Le Rouilly.

Mesothelioma patients are susceptible to anemia, a decrease in red blood cells that limits oxygen supply, often caused by the cancer itself or from the effects of chemotherapy, according to CancerConnect.com. Red blood cells contain the protein hemoglobin, which carries oxygen to all parts of the body, and in severe cases, patients may need a blood transfusion.

Harnessing this hemoglobin could transform medicine by providing a blood substitute that could save lives, speed recovery after surgery and help transplant patients, according to the research team.

There is still plenty more work to do in the lab, but if the researchers are able to bring it to market, there are plenty of other life-saving uses for the lugworm. The team even envisions using “freeze-dried lugworm blood” as blood supply backup after disasters and in combat zones.

Sources

BBC
http://www.bbc.com/news/health-40730875
Wyss Founding Director Donald Ingber
https://wyss.harvard.edu/sticky-when-wet-strong-adhesives-for-wound-healing/
journal Science
http://science.sciencemag.org/content/357/6349/378
MedicalXpress
https://medicalxpress.com/news/2017-07-story-worm-bringer-medical-miracles.html

Drug Therapy for Pleural Mesothelioma Care

Combination Drug Therapy Approval for Lung Cancer Opens Door For Targeted Care for Pleural Mesothelioma

Lung cancer patients with a specific genetic mutation just received good news with the approval of a combination drug treatment. The U.S. Food and Drug Administration announced in June that it approved dabrafenib and trametinib as a combination therapy for use in non-small cell lung cancer patients expressing the BRAF V600E mutation. Certain pleural mesothelioma patients may also benefit from this recent approval.

The FDA approved the two drugs from Novartis Pharmaceuticals Inc., Tafinlar (dabrafenib) and Mekinist (trametinib), based on success in a clinical trial of 93 patients with a median duration of response that ranged from six months to 12.6 months (depending on previous treatment status), according to a June 22 press release. The FDA also approved the Oncomine Dx Target Test to select those patients with NSCLC with the BRAF V600E mutation for treatment.

Novartis reports that “there is an urgency to treat people with this mutation, as BRAF V600E mutation-positive tumors have been shown to be more aggressive and may lead to a poorer prognosis.” According to Novartis, BRAF mutations are in just one to three percent of NSCLC cases worldwide. One study shows that BRAF is also a rare type of mutation in pleural mesothelioma, however, for an already rare disease with few treatment options, this approval brings a glimmer of hope to patients.

“Patients with BRAF V600E mutation-positive metastatic NSCLC have responded less favorably to standard chemotherapy, suggesting that there is a critical need for a targeted therapy,” said Bruno Strigini, CEO, Novartis Oncology, in a June 22 press release.

Treatment for pleural mesothelioma, an asbestos-caused cancer affecting the lining of the lungs, and non-small cell lung cancer is often similar, with chemotherapy being one of the primary treatment modes. Chemotherapy is used to manage symptoms and to slow the growth of the disease, but both cancers are notably aggressive and often develop resistance to the drugs, and, eventually, the treatment fails.

This double therapy oral treatment is another step towards personalized cancer care that could benefit those battling mesothelioma. Personalized care targeted to a patient’s unique characteristics and genetic makeup, such as the BRAF biomarker, optimizes the potential for success of the treatment.

“This is an important milestone for the lung cancer community as we are continuing to better understand the genomic drivers of cancer and develop effective treatments targeted for these biomarkers,” said Bruce Johnson, MD, Professor of Medicine, Chief Clinical Research Officer, Dana-Farber Cancer Institute and Harvard Medical School at Dana-Farber Cancer Institute.

This is the first approval for targeted treatment in the U.S. specifically for BRAF V600E mutation-positive metastatic NSCLC.

Talk to your mesothelioma care team to find out if this combination therapy will work for you.

Daughter of Mesothelioma Victim Holds Memories

A song. A simple tune that other passers-by don’t even notice. A smell, wafting on the breeze. A place, so full of meaning, that sharing it with other people seems like you’re telling a secret. These are all triggers for me; triggers of beautiful memories of my father. Knowing that I don’t have the chance to make new ones with him, makes me protective and possessive of the ones I hold so close to my heart.

Dad loved music and he was a beautiful singer. Even though he played with his bluegrass band, most of my memories of him singing were a bit different. Yes, he always sang me “You Are My Sunshine,” but there was more to it than that. I remember during our infamous Saturday morning adventures when he would sing along with me to the radio when REM or No Doubt was playing. I remember the time he went to an NSYNC concert with me, just because.

Along with music, my father was a lover of food. It didn’t have to be a delicacy, in fact, he would prefer it not to be. The smell of no-bake cookies reminds me of the first time we “baked” together, unsuccessfully, may I add. How we managed to mess them up, I’ll never know. The fun was in the experience.

Every time I smell a beautiful fall breeze, it takes me back to nights spent with him in the yard at our home, playing outside. Volleyball became a specialty, and during the last set of the night, we would both agree that we would go inside once the ball hit the ground. This led to bouts of hilarious laughter as we would run around, doing everything we could to make the evening last just a bit longer.

Dad and I shared so many memories in various places. Some of the memories I treasure the most are ones that I choose not to share. They are embedded deep within me; the stories that usually ended with “Don’t tell Mom!” are ones that only we knew. Now, I am left to reminisce about these alone. They were our secrets, and I intend to continue keeping them.

Now, my memories of my beautiful father are all that I have left of him. This harsh truth of my new reality reminds me to treasure each day. As you walk through life, stop and think that you might be creating memories that your loved ones will carry with them for years. Live each second with that thought; if you do, you’ll do a lot more living, and create a lot more unforgettable moments.

Know more about mesothelioma and how to deal with it.

Two Gene Therapys Brings Hope to Mesothelioma

Two Gene Therapy Approaches Pending Approval from FDA Bring Hope to Mesothelioma Community

Nearly five years ago, MesotheliomaHelp reported about a breakthrough treatment called gene therapy. At the time, it was touted as the “next frontier” in medicine, and cancer patients from around the world watched closely in the hopes that the treatment could bring a cure to even the rarest of cancers, such as mesothelioma. Now, all eyes are on the U.S. Food and Drug Administration as it is poised to approve two types of gene therapy.

The Oncologic Drugs Advisory Committee (ODAC) sent its recommendation to the FDA on July 12 for CTL019 (tisagenlecleucel) for the treatment of a form of leukemia. Then, on July 17, the FDA accepted a Biologics Licensing Application from Spark Therapeutics for gene therapy for a rare inherited eye disease that causes blindness, approved the name Luxturna for the treatment, and assigned priority status to the treatment for accelerated review.

To better understand these two pending landmark approvals and the future of gene therapy, MesotheliomaHelp turned to Ricki Lewis, a New York-based geneticist and author.

“It’s not right for every disease,” said Lewis. “But it is an approach that can be considered some day along with drugs, surgery and everything else.”

CTL019: CAR-T Treatment for Leukemia Ramps Up the Immune System

Tisagenlecleucel is an investigational chimeric antigen receptor (CAR) T cell therapy from Novartis, developed by researchers at the University of Pennsylvania. The pharmaceutical company wants to use the therapy to treat a rare form of leukemia, B-cell acute lymphoblastic leukemia affecting children and young adults under the age of 25, according to NPR.

Lewis explains that CAR-T therapy is not “conventional” gene therapy, which has been in clinical trials to treat single-gene diseases since 1990. However, she notes that “CAR T cell technology has had astonishing success in treating a form of leukemia and it’s being tested for multiple myeloma, brain cancer, breast cancer, and soft tissue cancers.”

“Although both approaches deliver DNA in viruses, classical gene therapy adds a working copy of a single mutant gene, restoring a specific protein’s function,” says Lewis. “Revving up a not-naturally-occurring immune response isn’t the same thing as replacing an enzyme,” which is what Luxturna does.

According to the National Cancer Institute, in CAR-T treatment, T cells are removed from the patient’s blood and genetically altered in a lab to have chimeric antigen receptors on their surface. The T cells are then multiplied, into the billions, in the lab and infused back into the patient’s blood, where they seek out the cancer cells and launch a precise immune attack against them.

Lewis offers the following explanation of CAR-T:

“CAR operates like a drone, targeting and obliterating cancer cells. It introduces a gene manufactured to contain instructions for making two immune system components in one, something that doesn’t exist in nature: an antibody and a T cell receptor. When delivered in a virus, the CAR enters the person’s T cells, which then manufacture the hybrid (chimeric) protein.

The engineered receptor portion guides the T cells to a specific target – such as cancerous B cells – where the antibody part binds. The action alerts the immune system to respond and kill the cancer cells.”

Ultimately, CAR-T, also described as a process that genetically alters a patient’s own cells to fight cancer, could be used for many more diseases and cancers, and bring an effective treatment to mesothelioma patients.

In a 2013 article for MesotheliomaHelp, Lewis wrote about CAR-T treatment saying, “An ingenious technique that has vanquished leukemia in a handful of patients is also being applied to mesothelioma.”

Lewis highlighted the CAR-T process being used in a mesothelioma clinical trial from the University of Pennsylvania that uses the “doctored T cells,” known as chimeric immune receptor (CIR) instead of CAR, against mesothelin, a protein that is found to be in excess in mesothelioma and other cancers. The idea is that T cells led to the mesothelioma cells will attract an immune response, said Lewis.

Find out more about the mesothelioma clinical trial from the University of Pennsylvania here.

Luxturna Gene Therapy Treats Blindness, Could Lead to Treatment for Other Inherited Diseases

In her book The Forever Fix, Lewis followed the journey of the use of gene therapy to restore the vision of a young boy who was nearly blind from a hereditary disorder. The doctors added a working copy of a single defective gene in the New York boy’s eyes that prevented his eyes from using vitamin A to send visual signals to his brain. The treatment was a success: the boy’s vision was restored and no further treatments or surgery were required.

“Last week’s FDA advisory committee’s greenlight for CAR technology overshadowed a milestone for what is likely to be the first approval of classic gene therapy – for a form of inherited blindness,” Lewis told MesotheliomaHelp. “That’s the Leber congenital amaurosis type 2 – renamed ‘RPE65-mediated inherited retinal dystrophy’ – that I wrote my book about.”

In an interview with Lewis last week, Dr. Katherine High, MD, President, Chief Scientific Officer, and a founder of Spark Therapeutics, said of the future of gene therapy:

“I hope we will see continued accumulation of successful clinical results in a range of target tissues and continued progress in bringing gene therapy products to licensing. When gene therapy products are licensed, there will be increased interest in the medical community, and that will help to expand opportunities.”

Mesothelioma patients typically show disease symptoms years or even decades after exposure to asbestos, a known carcinogen. The cancer is eventually fatal, but aggressive therapy may prolong the lives of patients who are diagnosed early. Approximately 3,000 Americans are diagnosed with the cancer each year.

“Getting at the basis of why one person develops mesothelioma and another person doesn’t, that is going to hold a clue to really fighting it,” Lewis said, referring to a clinical trial conducted at Wake Forest University in 2013 to determine whether some mesothelioma patients are genetically predisposed to developing mesothelioma. “Then we will know what to do the gene therapy on.”

The pending FDA approvals could bring groundbreaking treatment to cancer patients and to patients with genetic diseases. Perhaps someday, mesothelioma patients will enjoy long, productive lives through gene therapy.

The FDA is not bound to follow the ODAC’s recommendations, however, the Agency nearly always follows the recommendation. Approval for CTL019 is expected in November. The FDA will decide on Luxturna in January, 2018.

About Ricki Lewis,PhD

Ricki Lewis is a science writer with a PhD in genetics. The author of several textbooks and thousands of articles in scientific, medical, and consumer publications, Ricki’s first narrative nonfiction book, “The Forever Fix: Gene Therapy and the Boy Who Saved It,” was published by St. Martin’s Press in March 2012. In addition to writing, Ricki provides genetic counseling for parents-to-be at CareNet Medical Group in Schenectady, NY and teaches “Genethics” an online course for master’s degree students at the Alden March Bioethics Institute of Albany Medical Center.

Read more about gene therapy on Ricki Lewis’s DNA Science blog.

Find out more about Ricki Lewis at her website.

Sources:

Spark Therapeutics
http://blogs.plos.org/dnascience/2017/07/20/luxturna-a-giant-step-forward-for-blindness-gene-therapy-a-conversation-with-dr-kathy-high/
DNA Science blog
http://blogs.plos.org/dnascience/

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