Mesothelioma: No Cure Yet, But Much Promise in New Therapies

Clinical Trialsby Mary Hesdorffer, NP, Executive Director of the Meso Foundation

Mesothelioma has often been referred to as a cancer resistant to chemotherapy. That attitude changed when in 2004, the combination of Alimta and Cisplatin demonstrated a survival advantage over Cisplatin alone. This was a large randomized study that paved the way for pharmaceutical companies to become interested in this disease often thought to be recalcitrant.

Today, rather than telling our patients to go home and get their affairs in order, we can instead provide them with a wide array of treatment options, whether first diagnosed, after a recurrence, or even after several prior regimens.

Having options is an incredible step forward in this cancer that even merely a decade ago was seen as hopeless. But with options also come some challenges.

One such challenge is the healthcare providers’ lack of time necessary to fully inform patients with mesothelioma about their options. For this reason, providers will often present only a few of the many options to their patients.

Patients are fortunate that some providers unable to fully perform this task are referring their patients to the Mesothelioma Applied Research Foundation. At the Meso Foundation, a dedicated nurse practitioner spends the necessary time to go through the options, taking into account insurance coverage, stage of disease, histology and readiness to participate in a clinical trial.

The initial presentation and consultation during this stage is often complicated by the physical, emotional and legal challenges associated with the diagnosis. Patients and family members are often in a “tail spin” and desperate for information that might lengthen survival time or better yet, make mesothelioma into a chronic disease. It is crucial that time is taken to consider all of the options in a calm, supportive environment to ensure that decision making is optimized.

I outlined below some very promising new clinical trials. PLEASE NOTE: This is not a comprehensive list of available trials. Each mesothelioma case is different, so please only use this list as a loose guide. To obtain a full consultation, which will take into consideration all available treatments, please contact Mary Hesdorffer, APRN.

Among treatment options available today are specialized forms of radiation therapy given before or following a surgical procedure. Recently, a small trial using IMRT (Intensity-Modulated Radiation Therapy) prior to an extrapleural pneumonectory (EPP) demonstrated a 50% increase in survival over historical controls. A randomized trial is now in the planning stages to confirm these results in a larger patient population.

There are other trials currently under IRB review that will look at IMRT following either an EPP or Pleurectomy Decortication (PD). Randomized trials are the only way for scientists to demonstrate whether an intervention is better than the standard of care.

In fact, a randomized trial of a PD vs. PD, coupled with photodynamic therapy (PDT) has recently commenced following an initial, single center, non-randomized trial, which reported a significant increase in overall survival, including patients with advanced disease.

Another trial I’d like to mention uses a vaccine (CRS207) prior to treatment with Alimta and Cisplatin. It has reported a 69% durable response. A larger trial is now underway to confirm these results with plans for a future randomized trial.

Patients who respond or are stable following treatment with Alimta and Cisplatin are also eligible for Defactinib, an agent targeting cancer stem cells with the goal of lengthening the time to relapse or perhaps, in the best case scenario, preventing relapse altogether.

In the second-line setting (for patients who have had a recurrence following first-line treatment), immunotherapy appears to have taken the lead with a multi-nation, placebo-controlled trial of the drug tremelimumab. In melanoma, this agent has induced durable responses and, so far, has shown much promise in mesothelioma.

Definitely worth mentioning is also the NCI’s stellar new drug SS1P, an immunotoxin which utilizes mesothelin (a protein) to gain entry into the cell. Early phase I studies have demonstrated results in advanced patients who had failed multiple prior treatments, and a phase II study is currently underway.

These are just a few of the trials currently offered to mesothelioma patients. We strongly urge clinicians to refer patients to clinical trials in mesothelioma, as they are known to expedite research progress.

For instance, children’s cancers that saw the highest enrollment in clinical trials have experienced significant advances in treatments of those conditions. Our hope is to do the same for mesothelioma.

Visit curemeso.org to view the Meso Foundation’s Clinical Trials Brochure and learn more about enrolling in a clinical trial.

Get Ready for Meso Awareness Day 2014

Jill Waite Fundraising EventMesothelioma Awareness Day is just around the corner on September 26th! Established by Meso Foundation volunteers in 2004, Meso Awareness Day has been the driving force behind the movement to bring more attention and funding to this cancer. In the last ten years, through various activities, the Meso Foundation and its volunteers have been able to obtain “National Mesothelioma Awareness Day” proclamations by both the U. S. Senate and the House of Representatives, have raised nearly a million dollars, have received local government proclamations in their states and localities, and have received dozens of instances of media coverage for their stories, events, and activities.

In 2014, help us continue this trend. There are a number of ways that you can get involved, such as:

GOVERNMENT: Make Mesothelioma Awareness Day an official day in the states and cities where this hasn’t yet happened.

FUNDRAISING: Organize/attend a fundraising event. Visit curemeso.org to view upcoming events or explore the many ways you can get involved and plan your own event.

MEDIA COVERAGE: Contact your local media to obtain coverage of Meso Awareness Day in your area.

GENERAL AWARENESS: Use your social media networks to bring attention to mesothelioma and to educate your friends, families, and communities about our mission to eradicate mesothelioma and end the suffering caused by this cancer.

CONFERENCE: Join the Meso Foundation at the University of Pennsylvania in Philadelphia for a regional conference with experts in the field of mesothelioma. The conference will take place on Friday, September 26 at The Hub, Cira Centre located at 2929 Arch Street, Philadelphia, PA 19104.

TODAY SHOW: If you are in the New York are, join Meso Foundation volunteers as they again gather at Rockefeller Plaza in New York City for the Today Show on the morning of Friday, September 26. Check out the video below from Meso Awareness Day 2012!

More information about Mesothelioma Awareness Day is available on our website at curemeso.org/awarenessday.

Mark Your Calendar for Upcoming Mesothelioma Conferences

2013 International Symposium on Malignant MesotheliomaThis year, the Meso Foundation will be host to two regional conferences. The first will be held on Friday, September 26 at the University of Pennsylvania in Philadelphia, Pennsylvania. The second will be held on Friday, October 10 at the University of Chicago in Illinois. Each conference will feature regional experts in the field of mesothelioma. Check back to curemeso.org for further information as it becomes available or sign up for our e-news to ensure you are notified as conference details are released.

September 26, 2014
University of Pennsylvania
The Hub, Cira Centre
2929 Arch Street
Philadelphia, PA 19104

October 10, 2014
University of Chicago
Palmer House Hilton
17 E Monroe Street
Chicago, IL 60603

Annual Conference
The Meso Foundation’s annual conference, the International Symposium on Malignant Mesothelioma, along with the Scientific Seminar, will be held from Monday, March 2 through Wednesday, March 4, 2015 in partnership with the National Cancer Institute in Bethesda, Maryland. Events will be held at the National Institutes of Health Natcher Conference Center and the Hyatt Regency Bethesda. Symposium registration will open on October, 13, so mark your calendars now! Visit curemeso.org/symposium for more information as it becomes available or sign up for our e-news to be notified about Symposium details.

International Symposium
on Malignant Mesothelioma
March 2- 4, 2015
National Institutes of Health
Natcher Conference Center (Building 45)
Bethesda, MD
Hyatt Regency Bethesda
7400 Wisconsin Ave
Bethesda, MD 20814

Scientific Seminar
March 2-3, 2015
National Institutes of Health
Natcher Conference Center (Building 45)
Bethesda, MD

 

Meso Warrior, Rich Mosca, Featured on Everyday Health

Curemeso.orgLast week, mesothelioma survivor and mesothelioma community member, Rich Mosca, shared his powerful story of diagnosis and the beginning of his eight-year battle with meso on Everyday Health.

Mesothelioma is known to be very difficult to treat. But before treatment can even begin, a patient needs a diagnosis. In his contribution to the My Cancer Story section of the popular website, Rich details the long road it took to finally learn he has mesothelioma, and the unexpected relief of obtaining the diagnosis.

“Having no idea what was wrong, we had no idea what to do,” says Rich in his blog.

Rich’s story points out what is, perhaps, the disconnect in the world of mesothelioma – so many have heard about it from TV commercials, yet so few doctors actually think about it when patients present with certain symptoms.

To read Rich’s article, “Despite the TV Ads, Even Doctors Didn’t Know Much About My Cancer” in its entirety, please visit Everyday Health.

Update on the Deadliest Cancers Caucus

Deadliest Cancers Caucus briefingOn May 8, a Dear Colleague letter was sent out by the founding co-chairs of the newly established Congressional Caucus on the Deadliest Cancers to invite other Representatives to join the Caucus. According to the Dear Colleague letter, the Caucus was created “Because almost half of all cancer deaths in the U.S. are attributable to one of the deadliest cancers, it’s imperative that we monitor implementation and what, if any, additional steps Congress should take to address these most lethal cancers.” The caucus was founded by Representatives Leonard Lance (R-NJ), Anna Eshoo (D-CA), Dave Reichert(R-WA), and Henry Waxman (D-CA).

We asked meso advocates to contact their Representatives to ask them to join this important Caucus. There are now 20 members, which is a direct result of the advocacy efforts of the Meso Foundation and the other members of the Deadliest Cancers Coalition. Thank you to all of the mesothelioma advocates that took the time to contact their Representatives!

The Coalition also planned a June 19 briefing about the bipartisan Caucus, which was attended by more than 100 Congressional staffers. Meso Foundation Director of Government Affairs Jessica Barker attended the standing room only briefing.

Below, you will find a list of the current Caucus members. Don’t see your Representative on the list? It’s not too late! Visit our Action Center now to ask your Rep to join this important effort!

Current Members
Rep. Matt Salmon (AZ-5) – June 18, 2014
Rep. Anna Eshoo (CA-18) – May 2, 2014
Rep. Zoe Lofgren (CA-19) – June 19, 2014
Rep. Adam Schiff (CA-28) – June 18, 2014
Rep. Henry Waxman (CA-33) – May 2, 2014
Rep. Alan Lowenthal (CA-47) – June 23, 2014
Rep. Joe Courtney (CT-2) – June 19, 2014
Rep. Tom Latham (IA-3) – June 19, 2014
Rep. Joe Kennedy (MA-4) – June 19, 2014
Rep. Ann Wagner (MO-2) – June 19, 2014
Rep. Carol Shea-Porter (NH-1) – June 19, 2014
Rep. Leonard Lance (NJ-07) – May 2, 2014
Rep. Rush Holt (NJ-12) – June 19, 2014
Rep. Carolyn Maloney (NY-12) – June 18, 2014
Rep. Steve Stivers (OH-15) – June 19, 2014
Rep. Allyson Schwartz (PA-13) – June 19, 2014
Rep. Joseph Pitts (PA-16) – June 18, 2014
Sen. Sheldon Whitehouse (RI) – June 9, 2014
Rep. Michael Burgess (TX-26) – June 19, 2014
Rep. Dave Reichert (WA-08) – May 2, 2014

Learn more about the Meso Foundation’s advocacy efforts and how you can get involved at curemeso.org.