Cancer Resources

Another interesting study is called, “Gefitinib in Patients with Malignant Mesothelioma: A Phase II Study by the Cancer and Leukemia Group B” – Clinical Cancer Research March 2005 11; 2300 by Ramaswamy Govindan, Robert A. Kratzke, James E. Herndon II, Gloria A. Niehans, Robin Vollmer, Dorothy Watson, Mark R. Green, Hedy L. Kindler and on behalf of the Cancer and Leukemia Group B. Here is an excerpt: “Abstract – Purpose: The Cancer and Leukemia Group B conducted a phase II study of gefitinib, an inhibitor of the epidermal growth factor receptor (EGFR) tyrosine kinase, in patients with previously untreated malignant mesothelioma. Experimental Design: Eligible patients had unresectable pleural or peritoneal mesothelioma, measurable disease, no prior therapy, and performance status 0-1 by Cancer and Leukemia Group B criteria. Gefitinib (500 mg p.o.) was administered once a day for 21 days. Patients underwent restaging after every two cycles. Therapy was continued until disease progression or unacceptable toxicity. Results: The most common grade 3 toxicities were diarrhea (16%) and nausea (12%). Of 43 patients enrolled, 1 patient (2%) had a complete response, 1 patient (2%) had a partial response, 21 (49%) had stable disease lasting two to eight cycles, 15 (35%) had progressive disease, and 5 (12%) had early deaths. One-year survival was 32% [95% confidence interval (CI), 21-50%]. Median survival and failure-free survival were 6.8% (95% CI, 3.5-10.3) and 2.6 months (95% CI, 1.5-4.0), respectively. The 3-month failure-free survival was 40% (95% CI, 25-56%). EGFR expression score by immunohistochemistry done in 28 patients was categorized as low (EGFR 1+ or 2+) or high (EGFR 3+) expression: 97% had EGFR over[removed]2+ or 3+). The median and 3-month failure-free survival were 3.6 months and 40% for those patients with low EGFR expression compared with 8.1 and 40% for those with high EGFR expression.” Continue reading ‘Unresectable Pleural and Peritoneal Mesothelioma Research’ »

An interesting study is called, “Aggressive multimodality therapy for malignant pleural Mesothelioma” – The Annals of Thoracic Surgery – Volume 58, Issue 1, July 1994, Pages 24-29 by Thomas W. Rice MD, David J. Adelstein MD, Thomas J. Kirby MD, Matthew G. Saltarelli MD, Siva R. Murthy MD, Marjorie A. Van Kirk RN, Herbert P. Wiedemann MD and James K. Weick MD – Here is an excerpt: “Abstract – Nineteen patients with clinical stage I malignant pleural mesothelioma were treated with aggressive multimodality therapy. Nine patients underwent pleurectomy and decortication followed by immediate intrapleural chemotherapy with cisplatin and mitomycin C. Ten patients required pleuropneumonectomy followed within 1 week to 2 weeks by intrapleural administration of cisplatin (100 mg). Four to 8 weeks after operation, 15 patients underwent postoperative adjuvant cisplatin-based systemic chemotherapy. There were three postoperative complications (16%) requiring reoperation and one postoperative death (5%). Intrapleural chemotherapy was well tolerated with no complications. Systemic chemotherapy was poorly tolerated, and there was one chemotherapy-related death. Sixteen patients (84%) experienced good to excellent palliation. Three patients are currently alive with no evidence of recurrent disease at 10, 35, and 43 months. The median overall survival was 13 months and the median disease-free survival, 11 months. Overall and disease-free 3 year survivals were 17% and 22%, respectively. Patients with epithelial malignant pleural mesothelioma had significantly better overall survival (p = 0.037) and disease-free survival (p = 0.02) than patients with sarcomatous or biphasic malignant pleural mesothelioma. We conclude that despite major toxicity, in select patients with clinical stage I malignant pleural mesothelioma, aggressive multimodality therapy offers effective palliation and occasional long-term disease-free survival.” Continue reading ‘Pleurectomy and Decortication Followed by Immediate Intrapleural Chemotherapy’ »

Another interesting study is called, “Value of calretinin immunostaining in differentiating epithelial mesothelioma from lung adenocarcinoma.” By Ordóñez NG. The University of Texas M.D. Anderson Cancer Center, Houston 77030 – Mod Pathol. 1998 Oct;11(10):929-33.  Here is an excerpt: “Abstract – Only recently have immunohistochemical markers been recognized that are commonly expressed in epithelial mesotheliomas but not in adenocarcinomas. Among these, calretinin generated a great deal of interest, but the number of studies evaluating the practical use of calretinin immunostaining in the diagnosis of mesothelioma is limited, and the study results are controversial. To evaluate whether calretinin immunostaining can assist in distinguishing between epithelial pleural mesothelioma and lung adenocarcinoma and other carcinomas metastatic to the pleura, 38 pulmonary adenocarcinomas, 117 nonpulmonary adenocarcinomas, 28 squamous cell carcinomas of the lung, 8 large-cell undifferentiated carcinomas of the lung, and 9 transitional cell carcinomas metastatic to the lung were studied. Reactivity was observed in all of the 38 mesotheliomas, whereas only 3 of the 38 pulmonary adenocarcinomas and 11 of the 117 nonpulmonary adenocarcinomas (5/38 ovarian, 2/15 endometrial, 2/23 breast, 2/16 colonic, 0/8 kidney, 0/8 prostatic, 0/6 thyroid, and 0/3 pancreatic) exhibited weak or focal staining. Eleven of the 28 squamous carcinomas of the lung were also positive. No reactivity was observed in any of the large cell undifferentiated carcinomas of the lung or in the transitional cell carcinomas. It is concluded that calretinin immunostaining is not only helpful in discriminating epithelial pleural mesotheliomas from pulmonary adenocarcinomas but that it can also assist in distinguishing epithelial mesotheliomas from nonpulmonary adenocarcinomas metastatic to the pleura.” Continue reading ‘Mesothelioma and the Potential Accessibility of Tumors’ »

Another interesting study is called, “Neoadjuvant Chemotherapy Followed by Extrapleural Pneumonectomy in Malignant Pleural Mesothelioma” by Walter Weder, Peter Kestenholz, Christian Taverna, Stefan Bodis, Didier Lardinois, Monika Jerman, Rolf A. Stahel – Journal of Clinical Oncology, Vol 22, No 17 (September 1), 2004: pp. 3451-3457.  Here is an excerpt: “PATIENTS AND METHODS: Eligible patients had MPM with clinical stage T1-3, N0-2, M0 disease considered to be completely resectable and a WHO performance status of 0 to 2. Neoadjuvant chemotherapy consisted of three cycles of cisplatin 80 mg/m2 on day 1 and gemcitabine 1,000 mg/m2 on days 1, 8, and 15, given every 28 days. Surgery had to consist of a complete extrapleural pneumonectomy, including resection of pericardium and diaphragm. Postoperative radiotherapy was to be considered for all patients.

RESULTS: Nineteen patients with MPM were included in this pilot study. According to the European Organization for Research and Treatment of Cancer prognostic score, two patients were in the good prognosis group, and 17 patients were in the poor prognosis group. The response rate to neoadjuvant chemotherapy was 32%. The major toxicity was thrombocytopenia. Extrapleural pneumonectomy was performed in 16 patients with no perioperative mortality. Major surgical complications occurred in six patients, and all were treated successfully. Thirteen patients received postoperative radiotherapy. The median survival time was 23 months. Two patients remain alive and free of disease 41 and 38 months after initiation of therapy. Continue reading ‘Mesothelioma and Neoadjuvant Chemotherapy’ »

Asbestos dust exposure can result in the development of disease.  This fact has been a strong impetus for research.  One interesting study involving the disease development in the lungs of rats is called, “Hydroxyl radicals are formed in the rat lung after asbestos instillation in vivo.” By Schapira RM, Ghio AJ, Effros RM, Morrisey J, Dawson CA, Hacker AD – Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin, Milwaukee – Am J Respir Cell Mol Biol. 1994 May;10(5):573-9.  Here is an excerpt: “The hydroxyl radical (.OH) has been implicated as a cause of lung injury following asbestos exposure. However, despite in vitro evidence associating asbestos with .OH production, there has been no demonstration of such generation in vivo. Continue reading ‘Lung Injury and Disease Resulting From Asbestos Exposure’ »