Summary of Mesothelioma Studies Presented at ASCO

Microscopeby Lee M. Krug, MD, Memorial Sloan Kettering Cancer Center

The American Society of Clinical Oncology meeting was held from May 30 – June 3, 2014 in Chicago. This is the largest oncology meeting each year with around 30,000 attendees from all over the globe who congregate to discuss the latest research in all cancer types. I will provide you with my annual summary of the most prominent studies in mesothelioma.

Randomized trial of arginine deprivation with ADI-PEG20: This abstract was presented by Dr. Szlosarek from the United Kingdom. Arginine is an amino acid that normal cells make using an enzyme called ASS (time to make the joke here!). However, many cancer cells lack the ASS enzyme so they cannot make arginine and they need to get it from outside the cell. ADI-PEG20 starves the cancer cells of arginine. In this trial, patients with mesothelioma were randomized to receive treatment with ADI-PEG20 or just supportive care. In order to qualify, the tumor samples were tested to make sure they had low levels of ASS. Side effects were very mild with this treatment. About half of the patients had stabilization of their disease. The time for cancer growth to occur was longer in the ADI-PEG20 arm, but only by a small margin (1.9 versus 3.2 months). A future study will combine ADI-PEG20 with chemotherapy, and that trial should open later this year.

Phase 2 study with tremelimumab: Probably the hottest drugs in oncology right now are the antibodies that boost the immune system. These types of treatment have shown great benefit in melanoma, lung cancer, and many others. Tremelimumab is one of these drugs, and this trial, conducted in Italy by Dr. Calabro and colleagues, showed that mesothelioma also responds to these therapies. Of the 29 patients, 14% of patients had shrinkage of their mesothelioma and 38% had stabilization. These data support the international, randomized trial with tremelimumab that is currently ongoing that will include 542 patients. If this large trial shows that tremelimumab improves survival, this drug will get FDA approval for mesothelioma.

Anti-mesothelin vaccine CRS-207 plus chemotherapy: Dr. Hassan from the National Cancer Institute reported these results. Mesothelin is a protein on the surface of mesothelioma tumors, and seems to be an excellent target for treatment. CRS-207 is a vaccine that increases the immune response against mesothelin. In this study, CRS-207 was given with pemetrexed and cisplatin. Nearly 70% of patients had shrinkage of their cancer, much more than usual with chemotherapy alone, and the responses seemed to last longer. These results should encourage a larger future randomized study.

Next-generation sequencing in mesothelioma: The report from Dr. Scagliotti at the University of Turin, Italy, described his findings from an analysis of gene mutations in a group of mesothelioma tumor samples. This type of testing has become critical for identifying potential targets in all cancers, and customizing treatment for each patient.


Lee M. Krug, MD, is an Associate Attending Physician in the Division of Thoracic Oncology, Department of Medicine at Memorial Sloan-Kettering Cancer Center in New York, New York, where he completed a fellowship and chief fellowship in medical oncology. Dr. Krug is the Director of the Mesothelioma Program at Memorial Sloan-Kettering Cancer Center. He is also the chair of the board of directors of the Meso Foundation.

Meso Foundation Program Expenditures Increased to 86% of Budget

Fiscal ResponsibilityAn audit of the Meso Foundation’s 2013 financial statements confirmed an increase of program expenditures to 86% of the Foundation’s budget. Consequently, the amount spent on management and fundraising has decreased to 5% and 9%, respectively.

“We are very proud of this result. When compared to other excellent charities, we spend at least 11% more than they do on programs,” said Melinda Kotzian, the chief executive officer of the Meso Foundation. “Most importantly, this number shows our donors our dedication to the development of life-saving treatments and services for our mesothelioma-affected community.”

The Meso Foundation is the only mesothelioma-related charity to hold a 4-star rating by Charity Navigator and the only mesothelioma charity accredited by the Better Business Bureau.

The complete set of audited 2013 financials will be available on the Meso Foundation’s website in the “About Us” section under “990 Forms and Audits.”

Visit curemeso.org to learn more about the Meso Foundation’s impact.

New User-Friendly Meet the Mesothelioma Experts Web Page Released

Meet the Mesothelioma Experts Web PageThe Meso Foundation has released a new version of its web page about the Meet the Mesothelioma Experts live broadcast series, which makes the recordings of this educational series user-friendly and easier to access.

Each recording is now listed with a photo of the speaker, the title of the session, and a brief description of the topic of discussion. Users can select the recording they want to listen to, which will lead them to a user-friendly audio player accompanied by a more in-depth description of the session and speaker.

The Meet the Mesothelioma Experts series is a live teleconference with the goal of providing patients, their family members, and other interested parties with the most up-to-date information on mesothelioma treatment and research, directly from the physicians pioneering these advances. After the live teleconference, each session is available as a podcast for users to listen to on the Meso Foundation website. Past podcasts have featured:

  • Dr. Lee Krug, Memorial Sloan Kettering Cancer Center
  • Dr. Dan Sterman, University of Pennsylvania
  • Dr. Raffit Hassan, National Cancer Institute
  • Dr. Julie Brahmer, Johns Hopkins
  • Dr. Tobias Peikert, Mayo Clinic
  • Dr. Joseph Friedberg, University of Pennsylvania
  • Dr. Valerie Rusch, Memorial Sloan Kettering Cancer Center
  • Melissa Culligan, RN, University of Pennsylvania
  • Dr. Evan Alley, University of Pennsylvania
  • Dr. Joanna C. Horobin, Verastem, Inc.

The topics of past sessions have included immunotherapy, gene therapy, drugs, clinical trials, and biomarkers. Topics are discussed through an informal interview, focusing on questions important to patients in particular. Listeners are encouraged to ask questions while listening to the call.

To view the newly released web page and listen to past Meet the Mesothelioma Experts podcasts, visit curemeso.org/experts.

Expanded Financial Assistance for Travel Expenses of Mesothelioma Patients

TravelLast week, we announced the expansion of our Travel Grant program for mesothelioma patients. The program, which was created initially to help mesothelioma patients who are in need travel to see a specialist for the initial consultation, will now also accept applications to cover traveling expenses of patients enrolled in clinical trials away from home, or those seeking new consultation following relapse. Each grant of up to $1,000 can cover lodging, transportation, and meals.

Mesothelioma treatment requires the expertise of a specialist who has extensive mesothelioma experience. Such experts are available at a limited number of centers, access to which often requires the patient to travel. Mesothelioma patients can greatly benefit from consulting with an expert. In many cases, following the initial consultation, the mesothelioma expert will be able to work with the patient’s local physician to guide them through a more specialized treatment.

“The Meso Foundation believes that every patient should have the chance to be seen by an appropriate mesothelioma expert, regardless of their ability to pay,” said Mary Hesdorffer, the executive director of the Meso Foundation and an expert nurse practitioner.

To qualify for the grant, a patient must show significant financial need and fit in one of the following categories:

  • Patients who must travel to receive expert care or an expert consult on their mesothelioma, and cannot afford to do so without assistance. Repeat visits are not covered unless patients are enrolled in a clinical trial.
  • Following treatment by a specialist, the patient has relapsed and needs to explore a new option of treatment or clinical trial.
  • The patient has enrolled in a clinical trial and does not have the financial means to travel to appointments. We recognize that clinical trial participation requires multiple visits and will consider each visit as a new application.

More information about the Travel Grant program can be obtained by contacting the Meso Foundation at (877)636-6376 ext. 3821 or by emailing Dana Purcell at dpurcell@curemeso.org.

Visit curemeso.org for more information about mesothelioma.

GUEST BLOG: Sarah Lackner Attends the Charlie Cole Golf Classic

Lynn Cole and Sarah Lacknerby Sarah Lackner

I spent the third weekend in May in Asheville, North Carolina on behalf of the Meso Foundation at the 3rd Annual Charlie Cole Golf Classic hosted by Lynn Cole, along with her children, Matt and Katie, in memory of her husband, Charlie, who lost his battle with mesothelioma on March 31, 2010 after only 17 months.

I hadn’t met the Cole family prior to this weekend, but what occurred during that quick less-than-48-hour trip is exactly what the Foundation is about. The warmth and strength that the family displayed, their incredibly supportive and loving friends, as well as other local meso community members all contributed to making the day an absolute success.

Not only was I able to thank the Cole family for their commitment, their friends and family for their support, I was able to spend time truly connecting with each of them. Katie and I were the same age when we lost our parent and zipping around on the golf cart gave us a few hours to share our experiences, both of the loss and of life after the loss. Later that evening, Matt and I were able to also have those conversations that only occur with someone who has been through what we as a community go through. C.S. Lewis says that friendship is born that moment when one man says to another “What? You too? I thought that no one but myself…”

Charlie Cole Gold ClassicThis event was, for me, everything that the Foundation works for: supporting research, education, support, and advocacy programs through raising funds and awareness as well as bringing together those affected by mesothelioma. It takes what is often an isolating disease and provides a place where if you want to talk about it, everyone understands, and if you don’t want to talk about it, everyone understands.

Thank you, so much, Lynn, Matt and Katie for allowing me to share the weekend with you. And thank you for believing in and working towards a cure.