BREAKING NEWS: Data Released from Anetumab Ravtansine Study

VaccineLast week, at the World Conference on Lung Cancer, Dr. Raffit Hassan presented promising data on a novel agent, anetumab ravtansine, also known as BAY 94-9343. Anetumab ravtansine is an antibody-drug conjugate directed against the target molecule mesothelin which is highly expressed on mesotheliomas.

“Anetumab ravtansine shows encouraging efficacy in patients with advanced mesothelioma which warrants further study,” stated Dr. Hassan, a senior investigator and the head of the Thoracic and Solid Tumor Immunotherapy Section at the National Cancer Institute who has been working on developing mesothelin targeted therapies for patients with mesothelioma and other cancers for the last two decades.

This was a phase I study to determine the safety and activity of anetumab ravtansine in patients with cancer who had failed standard therapies. Based on early results of this trial more mesothelioma patients were enrolled to better define the activity of this drug in patients with pleural mesothelioma who had progressed on chemotherapy. Out of the 16 mesothelioma patients treated at the maximum tolerated dose, 5 (31%) had objective tumor shrinkage while 7 (44%) had stable disease. However, out of the 10 mesothelioma patients who received anetumab ravtansine as second line therapy 5 (50%) had objective tumor shrinkage and 4 (40%) had stable disease. In most patients the tumor response was very durable with three patients still receiving the drug more than 2 years after starting therapy.

Antibody-drug conjugates (also known as ADCs) are a new class of drugs that function by linking a particular antibody to a cancer-fighting drug. When combined, the antibody precisely targets the cancer cell, delivering the drug directly to it, thus avoiding extensive damage to healthy cells typical of traditional chemotherapies.

Using Herbs and Dietary Supplements During Mesothelioma Treatment

SpicesOver the last several year or so, a number of people have posted information about various supplements they favor, both for general health and, occasionally, as specific alternative remedies meant to bolster cancer treatment or prevention.  A number of our mesothelioma warriors have used yoga or stretching regimens to aid in post-surgical tissue relaxation, and others employ meditation or focused cognition to aid in mood and pain management. These non-invasive techniques have conferred varying levels of positive results, and pose no particular interactive problems with standard oncology therapy. Others, however, use one or more complementary therapies (e.g., naturopathy, homeopathy) or supplements (e.g., ginseng, green tea extracts), which could cause interactions with standard treatment if the proper care is not taken. Here, we provide some reference material to help anyone considering using such therapies or supplements.

A wealth of reputable and relevant information is easily available. For example, the professionals at Memorial Sloan Kettering Cancer Center (MSKCC) have a botanical expert pharmacist who monitors current science regarding herbs, botanicals, and other supplements. This is part of MSKCC’s Integrative Medicine Services. More information is available here.

Some herbs and dietary supplements are known to be detrimental to standard cancer treatment efficacy. One thing all reliable sources agree upon is that, before you start using any form of supplement or complementary medical treatment, you should tell your physician what you are considering.

MSKCC writes: “It’s important to tell your doctor or another qualified professional that you are using a dietary supplement. The reason for this is that an active ingredient in the product could interact with — increase or lessen — the effect of other medicines you’re taking.  People undergoing treatment for cancer should not receive any dietary supplements unless they’re prescribed by a doctor or given as part of a clinical trial that’s received [IRB] approval.”

NCI, in its Complimentary Alternative Medicine material, agrees: “Tell your doctor if you’re taking any dietary supplements, no matter how safe you think they are. This is very important. Even though there may be ads or claims that something has been used for years, they do not prove that it’s safe or effective.”

MD Anderson is in line in this herbal supplements article: “[Y]ou should approach herbal supplements with caution and speak with your doctor before taking any, whether you’re considering a pill, capsule, tablet or liquid form.”

The second important thing each of these expert facilities makes clear is that supplements – including herbs, vitamins, manufactured powdered weight controls, steroids, and all other over-the-counter materials are unregulated. The FDA treats supplements as foods. This means it does not verify any label claims (other than prohibiting specific disease prevention assertions). These materials are not subjected to clinical trials as they are understood in pharmaceutical development, and there is no control over additives, purity or the production methods.

Some manufacturers’ studies assert benefits in cancer treatment from use of their supplements. However, these are not the randomized, double blind studies we know as the gold standard for scientific study of new therapies. NCI and the National Center for Complementary and Integrative Health have begun clinical trials on a limited number of complementary therapies, but that data is still in development. The list and overview of these studies is available here.

If your research and medical team’s review lead you to try any of the hundreds of supplements advertised as health support, it is sensible to begin with a minimum dose. If the herb or compound neither helps nor hurts, you can slowly increase the amount or frequency of use. A measured approach will give you, and the physicians checking your blood analyses and scans, a better opportunity to detect any adverse effects before they become severe. Similarly, you can determine whether positive effects are amplified by increased dosage.

The following resources can provide you with additional information:

To read more about complementary and alternative medicine pertaining to mesothelioma patients, click here.

A Summary of Mesothelioma Studies from ASCO 2015

MicroscopeBy Hedy Lee Kindler, MD,  University of Chicago

The American Society of Clinical Oncology meeting was held from May 29 – June 2, 2015 in Chicago. About 30,000 attendees from across the world gathered to discuss the latest research advances in all types of cancer, making this the largest, most important oncology meeting of the year. This was a particularly exciting meeting for those of us interested in mesothelioma. I’ve summarized 3 of the most prominent studies below.

MAPS: A randomized trial of pemetrexed, cisplatin with or without bevacizumab. This oral abstract, presented by Dr. Gerard Zalcman on behalf of the French Cooperative Thoracic Intergroup (IFCT), was clearly the star of the show for those of us who care about mesothelioma. This study is important because it is the first randomized trial in over a decade to show that a new drug improves survival in mesothelioma patients. Bevacizumab is a monoclonal antibody that targets vascular endothelial growth factor (VEGF), which is highly expressed on mesothelioma. Think of it as a drug that targets the blood vessels that feed tumors (angiogenesis). Bevacizumab (the trade name is Avastin) is already FDA approved in multiple cancers, including colon cancer and lung cancer. In the MAPS trial, all 448 patients received standard chemotherapy with pemetrexed plus cisplatin, and half of the patients were randomized to also receive bevacizumab with each dose of chemotherapy. After completing 6 cycles of chemotherapy, patients on the bevacizumab arm also received bevacizumab by itself, every 3 weeks until their cancer started to grow. The time for cancer growth to occur (progression-free survival) was about 2 months longer in the bevacizumab arm (9.59 vs. 7.48 months). Patients treated with bevacizumab also lived almost 3 months longer (18.82 vs. 16.07 months). The addition of bevacizumab did not make patients feel worse (it did not worsen quality of life), although it did cause increased side effects such as bleeding, high blood pressure, and blood clots. Because there was an improvement in survival with the experimental treatment, it is possible that this trial could lead to FDA approval of bevacizumab for mesothelioma—stay tuned!

NGR015: Randomized trial of investigator’s choice of chemotherapy with or without NGR-hTNF. Oral presentations at ASCO are only for the large randomized trials. At most ASCO meetings there are no mesothelioma presentations; this year, there were two! The second oral presentation was by Dr. Rabab Gaafar from Cairo, Egypt on behalf of an international group of investigators. All 400 patients on this trial previously received pemetrexed. They were randomized to receive either NGR-hTNF (another drug that targets angiogenesis) or placebo (sugar water).  In addition, patients could receive chemotherapy either with gemcitabine, vinorelbine, or doxorubicin, or no chemotherapy at all. Unfortunately, the addition of NGR-hTNF to chemotherapy did not affect how long the cancer was controlled, or how long the patients lived. Data is being analyzed to see if certain characteristics might predict which patients might benefit from this drug.

Mesothelin targeted immunotherapy CRS-207, plus pemetrexed/cisplatin chemotherapy. Dr. Raffit Hassan from the National Cancer Institute updated the results of this ongoing trial in a poster presentation. Mesothelin is highly expressed on the surface of mesothelioma. CRS-207 is a vaccine that increases the immune response against mesothelin, and may enhance the activity of chemotherapy. In this study, 2 doses of CRS-207 were given before pemetrexed and cisplatin, as well as after completion of 6 cycles of chemotherapy. Encouraging activity was observed: 60% of patients had tumor shrinkage, and another 34% had disease that did not grow. Thus 94% of patients had disease that was controlled with this experimental vaccine plus chemotherapy. This is much better than would be expected with chemotherapy by itself. Based on these encouraging results, a randomized study to test this combination compared with standard chemotherapy is in development.

Hedy Lee Kindler, MD, an internationally recognized authority on the treatment of mesothelioma, is a Professor of Medicine and the Director of the Mesothelioma and Gastrointestinal Oncology Programs at the University of Chicago. Dr. Kindler is a Past President of the International Mesothelioma Interest Group. She was a member of the Science Advisory Board of the Mesothelioma Applied Research Foundation from 2001-2014, and remains active with the Foundation.  Dr. Kindler chairs the Mesothelioma Subcommittee of the Alliance for Clinical Trials in Oncology, a national cancer clinical trials group. Her research focuses on the investigation of novel agents for the treatment of mesothelioma. Patients from throughout the United States come to Dr. Kindler’s Mesothelioma Clinic at the University of Chicago for her expert care and to participate in her many clinical trials. Dr. Kindler has been listed repeatedly in Best Doctors in America, America’s Top Physicians, America’s Top Doctors for Cancer, and Best Doctors in Chicago.

Remembering our Dad on Father’s Day

The Bendixesby Aria and Bella Bendix, Rising Leaders Council, Mesothelioma Applied Research Foundation. In memory of Ken Bendix, their father.

Father’s Day is a complicated day for the two of us. Every year as the third week in June approaches and the TV floods with Father’s Day commercials, or “Gifts for Dad” begin to appear in the aisles of department stores, we are reminded that our dad is no longer around. Many times, it can feel like a day of loss rather than celebration.

This year will mark our sixth Father’s Day since our dad’s passing. He was diagnosed with peritoneal mesothelioma in November of 2006 and, after a long and courageous fight, he passed away in September 2009. If it is said that our father lost his battle with cancer, he most certainly won the war that is life. When faced with improbable odds and at times unbearable pain, he still remained the kind, calm, selfless person we always knew him to be.

Father’s Day is a time to remember the person he once was—a silent warrior, doting dad, loving husband, and our family’s moral compass for nearly two decades. As fathers around the world unwrap fishing gear and golf clubs, t-shirts and photo frames, we unwrap the gift that is his memory, and celebrate the fact that it is still there to comfort us after all these years.

Even so, at times these memories are tinged with the pain of loss, and each year we are tempted to ignore Father’s Day altogether in order to circumvent this pain. To all those who have encountered loss in their lives, we speak from experience when we say that it is important to resist this temptation. In the midst of busy lives, it can be easy to neglect the memory of a loved one who is no longer around, to store it in that dangerous cubby of our minds that we promise ourselves we’ll access some day but rarely do. Father’s Day serves as a vital reminder of the life that we once knew, and the life that guides our thoughts and actions even when we’re not aware of it.

This Father’s Day, like many before it, our family will take a trip to Inspiration Point. A quiet little spot in Newport Beach that overlooks the ocean, it was my father’s favorite place to reflect while he was alive. Six years after his passing, we reflect in much the same way on all that he has given us, and all he continues to give us even after he is gone. These are gifts that can never be taken away, and it is important to unwrap them not only on Father’s Day, but whenever we may be feeling discouraged or sad.

It is our hope that, by recalling these memories, we can transform the loss we might feel at seeing a picture of a friend and her father on social media or a Father’s Day advertisement on TV into a moment of gratitude for the father we were fortunate enough to have. We anticipate it to be a lifelong objective, and we have no doubt that we will fall short many times. If our father has taught us anything, after all, it is that we are only human, and sometimes even the strongest of soldiers lose the battle. What matters, however, is that we continue to fight to honor our father’s memory, even when it might be painful to do so. After all that he has given us, this is our gift to him.

Meso Warrior Heather Nash Makes Video to Raise Awareness

Heather NashThe Meso Foundation was recently featured in a video released by a mesothelioma warrior, Heather Nash, whose goal was to correct misconception about this deadly cancer and to request that viewers support the Meso Foundation.

In the video, Heather leafs through written cardboard sheets from which the viewer learns about her story. On them, she says, “My name is Heather. I am a daughter. I am a wife. I am a mom. I was a nurse. I was healthy. I have cancer. Mesothelioma. Average life expectancy: 9 to 18 months. I need your help to find a cure. Please give at”

When asked about her reason for making the video, Heather explains that her goal was to show that the face of meso often isn’t the one seen on late night TV commercials.

“This cancer does not discriminate and I am an example of that,” says Heather.

“Also, being a relatively rare cancer, research into it gets little funding. I hope this video can help change that,” she added.

View the video below and visit to support the Meso Foundation’s life-saving programs and patient services.