REMINDER: Support Group Tonight — CAREGIVERS

For those of you new to the Meso Foundation blog, we offer many resources here ranging from Social Media Moments to updates from Capitol Hill to success stories from the front lines of fundraising. Beyond our blog, though, we also offer a wide variety of resources on our website — CureMeso.org. Alongside podcasts, an Advocacy Ambassador program, and answers to your questions on mesothelioma, we also offer support groups, hosted by our Nurse Practitioner, Mary Hesdorffer. We understand the mesothelioma experience can often feel daunting and isolating which is why, every two weeks, we offer telephonic groups where people gather, talk, and listen.

Tonight’s group is a Caregivers Group, meeting at 7:30 p.m. If you wish to register and join a group, please contact Mary at mhesdorffer@curemeso.org or call the Foundation at (877) 363-6376 or consult our website for details.

We hope to talk to you soon.

FROM THE FOUNDATION: Your Questions (and the Doctors’ Answers) from the 2012 Symposium

Currently happening at the Omni Shoreham Hotel in Washington, DC and hosted by the Mesothelioma Applied Research Foundation, the 2012 Symposium has brought together mesothelioma scientists, doctors, medical professionals, mesothelioma patients and their families, and other advocates together in order to showcase research, discuss options, and raise awareness in finding a cure for mesothelioma. While many are in attendance, there are some that for a variety of reasons cannot attend. This is one reason why we at the Meso Foundation have enabled a Live Stream that brings the Symposium to you.

The Meso Foundation has assembled an exceptional agenda featuring presenters such as Raja Flores, MD, Giovanni Gaudino, PhD,  Steven Hahn, MD,  Harvey Pass, MD, Daniel Sterman, MD, David Sugarbaker, MD, Raffit Hassan, MD,  Robert Kratzke, MD, Lee Krug, MD, and many others. The theme of the Symposium is “What’s Your Question?” and attendees have taken this to heart. Here are some of the questions our special guest physicians have addressed during our first Symposium Live Stream.

Q: How did the phase I clinical trial with the WT1 peptide vaccine go?

A: Stay tuned! I will be discussing the results in detail in the afternoon session.

Q: What is the role of photo-dynamic therapy following thoracic surgery for mesothelioma?

A: Photodynamic therapy involves the delivery of a drug that sensitizes a patient’s tissues to light, and then light is shined directed on the tumor tissue. This has been a strong area of research interest from Dr. Friedberg at the Univ. of Pennsylvania who uses it to treat the surface of the chest wall after surgery for mesothelioma. The effectiveness of this technique remains unclear, and he is the only one pursuing this approach at the current time. This has been studied previously by Dr. Pass who did not find it effective, though Dr. Friedberg may have more promising results. Photodynamic therapy may increase the risk of surgical complications, and should only be done in the setting of a clinical trial.

Q: I have blood in my urine. Can meso reach the kidneys?

A: There are many causes for blood in the urine (hematuria), the most common being a urinary tract infection. Others include bleeding issues (for example, for patients on blood thinners such as Coumadin), other drug toxicities, or tumors that start in the kidney or bladder. Hematuria caused by tumor metastases is much less likely. It would be quite rare for pleural mesothelioma to spread to the kidneys. Peritoneal mesothelioma could potentially cause it by invading into a part of the urinary tract. The work up would include a urine test for infection, imaging such as ultrasound or CT scan, and possible a cystoscopy (scope procedure to look in the bladder).

Q: Is there any relationship between having an EPP and being one of the fewer than 10% of patients who develop bone cancer?

A: I presume by “bone cancer,” you mean a metastasis (spread) of mesothelioma to the bone. This can unfortunately occur to some patients with advanced mesothelioma, regardless of whether or not they had surgery.

Q: Since my husband had meso, should my daughter be tested for the BAP1 mutation – or is it even available?

A: Although BAP1 mutations occur in about 20% of mesothelioma tumors, they are usually “spontaneous” mutations, and we think familial BAP1 mutations are the cause of mesothelioma for a relatively small percentage of patients. However, if there is a history of mesothelioma in other family members, or of melanoma, particularly ocular melanoma, then it would be reasonable to discuss the pros and cons of BAP1 genetic testing with a genetics counselor. Information on this gene is just now emerging, so we don’t yet know what to do with the results.

Q: Should patients have CT, PET/CT, or MRI for surveillance scans?

A: Radiology imaging for mesothelioma is notoriously challenging, and all of our current techniques have limitations. For patients with pleural mesothelioma, I generally follow them with simple CT scans. I find PET/CT most useful at diagnosis to determine the degree of tumor spread (stage of disease), though I think it can be difficult to interpret the significance of minor changes on the PET scan when used for follow up. MRI of the chest is less optimal due to respiratory motion that occurs during the longer time necessary to acquire the images. Newer imaging techniques are needed, and are being explored such as measuring tumor volume.

Q: Is there a consensus on how often a patient should be tested for recurrence?

A: No formal consensus, but the practice is to follow by physical examination CAT scan approximately every three months during the first year, then every six months for another 18 months, then yearly until five years. There is no consensus after five years but it is unlikely that continued surveillance will be of benefit.

Q: Where would you recommend someone to be tested for possible 

A: even in individuals heavily exposed to asbestos, the risk of mesothelioma is less than 1%, so that screening of asymptomatic individuals isn’t very helpful. Also,the interval between Asbestos exposure and the development mesothelioma is estimated to be greater than 15 years again making yearly surveillance not very helpful. Those who do have clear evidence of asbestos exposure such as pleural plaques, should be looked at at least once every two years by chest x-ray or CAT scan.

FROM THE HEADLINES: International Team from the University of Hawai’i Identifies Protein Critical in Development of Mesothelioma

Former Mesothelioma Applied Research Foundation’s grant recipient, Dr. Haining Yang  (University of Hawai’i), is once again making news with the recent discovery of a protein that is activated following exposure to asbestos leading to the development of malignant mesothelioma.  As reported by MedicalXpress.com, Dr. Haining Yang, PhD, and an international team of researchers have identified HMGB1 as a critical protein in the development of malignant mesothelioma. Dr. Yang’s findings are the cover story of the July 1’s Cancer Research, one of the nation’s leading cancer research publications.

“We are very excited about this discovery and are extremely pleased that it was also chosen to be the featured cover story,” said Yang. “The next step is to translate this discovery into actual treatments for mesothelioma patients.”

This discovery into the growth of mesothelioma offers scientists an opportunity to develop specific therapies for mesothelioma patients. Mesothelioma, a malignant tumor of the lining of the lung, abdomen, or heart known to be caused by exposure to asbestos is considered one of the most aggressive of all cancers. Approximately 3,000 Americans are diagnosed with mesothelioma every year, yet available treatments have limited effectiveness. Identifying this biomarker for early detection will help shed light on developing new treatments for mesothelioma prevention and therapy.

Earlier this year this same lab worked collaboratively with others to announce the first gene associated with malignant mesothelioma BAP1. Dr. Giovanni Gaudino from the University of Hawai’i will be discussing BAP1 and its possible utility as a target for therapy and identifying those at high risk to develop mesothelioma at the Meso Foundation’s 2012 Symposium during the “Demystifying Scientific Breakthroughs” panel. It is a very exciting time for mesothelioma research and the promise for further scientific breakthroughs will be the focus of discussion at the Symposium.

The current study was an international effort and included investigators from the University of Hawai‘i Cancer Center, the John A Burns School of Medicine in Honolulu, the San Raffaele University and Research Institute in Milan, Italy, the National Institutes of Health in Bethesda, Md., and the New York University School of Medicine.

Taking in the Sights: Things to Do in Washington D.C.

Before we know it, the Mesothelioma Applied Research Foundation’s 2012 Symposium will be happening. Some of you may be joining us online (and welcome aboard — make sure you have your questions ready for the asking!), but for those of you making the trip to the Nation’s Capital, maybe you will want to plan an extended weekend around your time with us.

Sounds like a solid plan as there is a lot to see and do in Washington. Just off the top of our heads, we can recommend:

Along with these sights, there are some terrific exhibits geared for all kinds of interests in the week of the 2012 Symposium: Continue reading “Taking in the Sights: Things to Do in Washington D.C.” »

GUEST POST: An ASCO Update from Dr. Lee M. Krug, MD

The Meso Foundation is happy to present this special guest blogpost from Lee M. Krug, MD, Associate Attending Physician in the Division of Thoracic Oncology, Department of Medicine at Memorial Sloan-Kettering Cancer Center in New York, New York and Director of the Mesothelioma Program at Memorial Sloan-Kettering Cancer Center. Dr. Krug has investigated multimodality approaches for patients with early stage malignant pleural mesothelioma, has led a multicenter U.S. trial of induction chemotherapy before extrapleural pneumonectomy, and has a current study testing the feasibility of chemotherapy followed by pleural radiation. Dr. Krug also has a strong interest in novel therapeutics for patients with more advanced disease, and is the principal investigator of an international, phase III trial of a histone deacetylase inhibitor, vorinostat. Dr. Krug led the committee for the National Comprehensive Cancer Network (NCCN) that established treatment guidelines for mesothelioma, and is currently the chairman of the Scientific Advisory Board and serves on the Board of Directors at the Meso Foundation.

The Annual Meeting of the American Society for Clinical Oncology (ASCO) was held in Chicago, IL from June 1-5, 2012. This is the largest meeting in oncology each year with over 25,000 attendees from all over the world. Several abstracts of interest to mesothelioma were presented, so I thought I would summarize the results of a few of the most interesting:

Randomized Phase II Trial of Pemetrexed/Cisplatin with or without CBP501 in Patients with Advanced Malignant Pleural Mesothelioma: CBP501 is a novel compound that enhances the ability of cisplatin to damage cancer cells. In this international trial, patients received treatment with standard chemotherapy (pemetrexed and cisplatin), or they received it in combination with CBP501. 63 patients participated in total; 40 were in the group with CBP501. The only additional side effect of CBP501 seemed to be a rash that occurred during the infusion. Forty percent of the patients who received chemotherapy plus CBP501 had tumor shrinkage as compared to 17% of the patients who received chemotherapy alone. The average time before the cancer grew back was 5.9 months in the CBP501 arm, and 4.7 months in the other arm. Although the patients who received chemotherapy alone fared less well than expected, the results seemed encouraging. Another similar trial with CBP501 has also been conducted in lung cancer and until those results become available later this year, plans for future trials are unclear. Continue reading “GUEST POST: An ASCO Update from Dr. Lee M. Krug, MD” »