Nurse Lauds New Mesothelioma Standard of Care

As a result of a clinical trial, there is exciting news that the standard of care for patients receiving chemotherapy for mesothelioma could be changing. Currently, the standard first line chemotherapy for mesothelioma is pemetrexed and cisplatin. It has been the standard since 2003.

What is the new drug that could change all this? Bevacizumab is the generic name, Avastin is the brand name. Avastin was approved for colon cancer by the FDA in 2004 to be used in combination with standard chemotherapy treatment. It works by inhibiting growth of blood vessels, angiogenesis, and was the first clinically used angiogenesis inhibitor.

This news came from the reporting of a clinical trial comparing the standard treatment of pemetrexed and cisplatin with the combination including the addition of bevacizumab. The trials indicated that overall survival and median progression free survival were longer in patients receiving the combination therapy of the three drugs as opposed to the current standard of therapy. The Mesothelioma Avastin Plus Pemetrexed-cisplatin Study (MAPS) trial was conducted by the French Cooperative Thoracic Intergroup (IFCT).

This is an important advance in the treatment of malignant mesothelioma. Together with other advances scientists are slowly putting together the puzzle that is malignant mesothelioma. Avastin is manufactured and distributed by Genentech. If you are a mesothelioma patient that is considering chemotherapy, ask your oncologist if you are a candidate for the new regimen.

Once again, the importance of clinical trial participation and collaboration may have helped progress towards a cure.

The cost of any new medication should not be a barrier to care. There are resources available, including the Genentech’s website, to find out about financial assistance in your use of the drug.

Precision Medicine Initiative for Mesothelioma Community

Mesothelioma Community Will Benefit from Precision Medicine Initiative

In October, Mesothelioma Help presented the National Institute of Health’s plan to fund and manage President Obama’s Precision Medicine Initiative. Now, 18 months after the President made bringing personalized health care to all Americans a focus, the White House has announced “new investments, partnerships, and policies that aim to bring us significantly closer to our goal” of fully utilizing technology and people. The mesothelioma community is watching this initiative geared towards ensuring U.S. patients get the treatments that will work best for them.

Mesothelioma is an asbestos-caused cancer that has few treatment options. However, recent research has turned the focus to personalized care and looking at the disease characteristics as opposed to using the most commonly used treatment protocol. Research has shown this is the best way to increase the survival for patients. This program will help bring tools and technology needed to help researchers continue down this path.

In a July 6 press release from the White House, the three key investments in the Precision Medicine Initiative (PMI) are:

$55 million from the National Institutes of Health (NIH) to recruit the volunteers needed for the PMI Cohort Program;
http://www.nimh.nih.gov/health/topics/depression/index.shtml
A U.S. Food and Drug Administration proposal to streamline its oversight of genomic tests; and,
Development of appropriate tools for researchers to access data.

PMI Cohort Program Gets Boost from Veterans

The ultimate goal of the PMI project is to create a database, through the PMI Cohort Program, containing genetic information, biological samples, and dietary and lifestyle information of one million Americans who volunteer to share this information and, potentially, their electronic health records. The $55 million is ear-marked to help health care provider organizations, technology developers, and community health centers launch the steps needed to recruit volunteers. This information will be used to “lay scientific foundation for precision medicine for many diseases,” according to the NIH.

Nearly 3,000 Americans are diagnosed with mesothelioma each year, and of those, one-third are military veterans. Although many veterans are unaware of this statistic that is a result of their years of service, many have stepped up to the plate once again to help their fellow Americans by allowing science to explore their medical data. As part of the PMI Cohort Program, the VA is partnering with the NIH to help enroll the nearly 500,000 who donated data to the Million Veteran Program, a VA-backed program similar to PMI’s, directly into the PMI Cohort Program and to share the VA’s successes.

Genetic Testing Offers Mesothelioma Patients A Chance at Increased Survival

Personalized medicine is considered the wave of the future, and one of the best ways to combat mesothelioma. Tailored care ensures a mesothelioma patient’s unique disease characteristics, including the cancer’s genetic makeup, are targeted when being treated, thus optimizing the potential for success of the treatment.

The FDA shoulders the responsibility of approving medical tests that identify specific biomarkers, such as the EGFR biomarker often targeted in mesothelioma, to support personalized care. Under the PMI, the FDA is developing “a flexible yet accountable approach to oversight of genomic technologies.” In addition, it will offer a platform and guidelines for researchers to compare the accuracy of their DNA sequencing tests.

“These new policies will make it easier for developers to market safe and effective genomic tests by relying on community-based standards and well-established sources of scientific evidence that meet appropriate standards,” according to the press release.

To find out more about the Precision Health Initiative visit the National Institutes of Health website.

Photo Credit: NCI

Memories Left Unmade Because of Mesothelioma

For most people my age, going to see your father entails conversing with the man that was always there for you, reminiscing about fond memories and creating new ones. Visiting my Dad used to mean walking into a home filled with his smile, laughter, and charm. It meant spending time with the person who was always there for me, someone who always would be. That was until mesothelioma became a part of our lives.

Now, visiting my father means driving up a long, windy road to the top of a hill. I get out of the vehicle, walk about 50 feet, and gaze upon a black piece of marble. I stop and talk to him, but I get no answer. There is no more of his laughter; that sound now only exists in my memory. Now, spending time with my Dad means going to a cemetery.

As I walk up to the place where we laid him to rest, I am always overcome with emotions that bring me to tears. I think of how much I miss him. I ponder why this had to become his fate. I try to hold back the anger I feel that he ended up with mesothelioma, and how it could have been prevented if only people had been more responsible. I wonder why anyone would take the dangers of asbestos so lightly that they would endanger other’s lives as if they were disposable.

Each and every person who has been a victim of this disease has a story. They have a family and people who love them. They are not nameless faces, they are God’s children. They are more than just a stone, marking where they now lie.

As I stand by my father’s grave, I remember his funeral and the outpouring of love that was present that day. I remember the smile he gave me the last time I saw him, and the last “I love you” over the phone, 45 minutes before he passed away. These are memories that I will always cherish, but I still long for the ones left unmade because of mesothelioma.

Know more about Mesothelioma and how you can deal with it.

Dr. Anne Tsao mesothelioma guest faculty member

Dr. Anne Tsao Shares Her Knowledge Through Online Curriculum

Anne Tsao, M.D., Director of the Mesothelioma Program and the Thoracic Chemo-Radiation Program at The University of Texas MD Anderson Cancer Center, is one of the leading authorities of mesothelioma in the United States, and she is also one of the strongest advocates for taking a personalized treatment approach to mesothelioma. She has treated hundreds of patients using the latest, targeted treatments available. Now, Dr. Tsao is sharing her knowledge of mesothelioma as a guest faculty member with Clinical Care Options.

Through Clinical Care Options online curriculum, Dr. Tsao discusses “current best practices and provides her perspective on the latest clinical trial data for the treatment of mesothelioma.” The program, targeted to physicians and other healthcare professionals who provide medical care to mesothelioma patients, has a goal “to improve participants’ ability to provide medical care for patients with mesothelioma and understand the significance of ongoing clinical research in this area.”

The online class walks the student through the diagnostic options, compares and contrasts the various chemotherapy options, highlights the latest mesothelioma treatment breakthroughs and provides updates on the latest mesothelioma clinical trials. The student’s knowledge is tested through several multiple choice questions.

“This is a very exciting time with many developments for mesothelioma care,” concludes Dr. Tsao. “We still need to identify prognostic and predictive biomarkers and use these to design our future targeted therapy trials,” and “we need to identify mechanisms for drug resistance by designing our trials to include biopsies at different time points during therapy,” adds Dr. Tsao.

About MD Anderson’s Mesothelioma Program

Mesothelioma is a rare form of cancer caused by past exposure to airborne asbestos fibers. The cancer is highly aggressive and is resistant to many current treatments. Just 3,000 Americans are diagnosed with mesothelioma each year.

Due to mesothelioma’s relative rarity among the general population, it is recommended that mesothelioma be treated by a team of doctors and surgeons led by a mesothelioma specialist rather than by one primary physician. Mesothelioma specialists are aware of the latest research, and they are able to develop a more informed treatment plan than would a physician who does not specialize in the disease.

“Because MD Anderson’s Thoracic Center cares for more patients with mesothelioma than almost any other center in the United States, you can be sure you are being cared for by renowned physicians with the highest levels of experience and skill,” as noted on MD Anderson’s website.

The Center’s Mesothelioma Program is comprised of a team of more than 30 experts representing medical oncologists, surgeons, radiation oncologists, pulmonologists and pathologists who work closely together to customize the best treatment for each patient. Everyone on the team is considered an expert in their field and in mesothelioma.

“This program not only has the clinical arm where we treat the patients, but it also has the clinical research program that offers clinical trials for every single setting for our patients,” said Dr. Tsao in a 2009 podcast for MD Anderson about new advances in mesothelioma. It also has a translational research program making it “one of the very few centers in the world that has such a comprehensive program.”

To find out more about Dr. Tsao and her research on mesothelioma see MD Anderson’s website.

Medical Team Supports Mesothelioma Patients in Making Care Decisions

According to a recent survey, 64% of respondents believe they could be making more decisions about their health and wellness. This national survey emphasizes the importance of empowering individuals with information within a dynamic healthcare environment. The survey by the National Council of Patient Information shows how important communication and trust is with your medical team. But unfortunately, more and more patients diagnosed with mesothelioma turn to the internet. This one-sided approach to learning about the disease can lead to unrealistic expectations, for both the patient and family.

This past week a man who had surgery a year ago, a pleurectomy, for malignant pleural mesothelioma was re-admitted to the hospital. His course has been complicated over the last year, and emotionally it has been a challenge. He has undergone chemotherapy, and fell and sustained bruises while being on a blood thinner. After surgery, both he and his wife felt that progress was way too slow. He was disappointed in how he felt. He wanted more out of himself physically and looked upon his slow progress as a failure on his part.

He was readmitted and found to have metastatic disease – his mesothelioma had spread. He was offered the options best suited him by his team. He could restart chemotherapy or he could elect to go home with hospice. Armed with his options, he was going home to think about his choices. Did he want to go through another round of chemotherapy or did he want to choose hospice? This is a very personal decision that he and his family had to make.

In order to make healthcare decisions, all questions must be answered, the information must be understood, and all communication must be clear. Whatever decision the patient makes will be fully supported by the medical team. As his journey continues with mesothelioma, the choices he makes will impact he and his family. What are his values? What does he value in his life? His decisions made with his family, and his medical team, will be based on what he wants.

Know more about Mesothelioma and how you can deal with it.

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