Sunday, August 30, 2009

Mesothelioma Claims Life of New Orleans Man

New Orleans resident William Simmons has passed away after battling mesothelioma. Mesothelioma, a rare form of cancer, is linked almost exclusively to asbestos exposure. The disease attacks the body aggressively, and has been known in some cases to kill patient's mere months after being diagnosed.

Simmons was 84, and had lived in New Orleans since the age of 5. Williams was the founder of a multi-million dollar industrial plating business, and it was Simmons' company that plated "the bumpers and all else that could be plated" on Fats Domino's legendary pink Cadillac. He also gold-plated an altar in a New Orleans church.

The business that grew to become Simmons Plating and Grinding Co. was launched with a $75 loan just after World War II. Simmons received the start-up funds from his uncle after his service in the Marine Corps. The New Orleans business grew slowly at first, as Simmons took night classes to learn the trade.

As Simmons furthered his education and received more practical experience, he was able to develop an improved technique of electroplating. He also designed a plating machine and built a coast-to-coast client list that included General Electric and many other companies along the lower Mississippi River and the Gulf Coast.

In his later years, the company developed coatings for rotating equipment such as compressors, turbines and gears. Simmons also served as a trustee of St. Luke's United Methodist Church. He is survived by longtime companion Barbara Ferguson, as well as his sister, Amelia Coghlan of Covington.

Friday, August 14, 2009

Exposure To Volcanic Mineral Associated With Increased Mesothelioma Incidence In Turkey

High exposure to a fibrous volcanic mineral called erionite was associated with a high incidence of a type of cancer called mesothelioma, according to a study in the March 15 issue of the Journal of the National Cancer Institute.

Many cases of environment-related mesothelioma have been reported in the Cappadocia region or Anatolian plateau of Turkey. Blocks of erionite from volcanic tuff have been used in construction, and storage rooms for produce have been cut in the tuff. Past reports have suggested that erionite exposure may increase the risk of mesothelioma, and studies have shown that erionite is associated with a higher risk of cancer development in animals than any other fiber previously tested.

Y. Izzettin Baris, M.D., of Hacettepe University in Ankara, Turkey, and colleagues followed 891 men and women age 20 years and older in three villages in Turkey -- two exposed to erionite, one control -- for 23 years. During this period, 372 deaths occurred, and 119 of these deaths occurred from mesothelioma. This form of cancer mainly affects the lining of the lung and was the cause of 44.5% of all deaths in the two villages with erionite exposure. Only two cases of mesothelioma occurred in the control village, both in people born outside of the control village.

The mortality data were analyzed jointly with Philippe Grandjean, M.D., Ph.D., of the Harvard School of Public Health. When standardized to the world population, the annual incidence of pleural mesothelioma in the two exposed villages was 200 and 700 cases per 100,000 people annually, compared to a rate of 10 cases per 100,000 people each year in the control village. The authors conclude that the long-term exposure to erionite is the cause of the exceedingly high risk of developing mesothelioma.

"Our results emphasize the severity of the mesothelioma endemic in erionite-exposed areas of Turkey," the authors write. They add, "In the rural part of central Anatolia, Turkey, millions of inhibitants are likely exposed to hazardous amounts of mineral fibers from the environment. Resources should therefore be directed to preventing these environmental exposures and additional study of the association between environmental exposure to nonasbestos fibers and the risk of cancer."

Citation: Baris YI and Grandjean P. Prospective Study of Mesothelioma Mortality in Turkish Villages With Exposure to Fibrous Zeolite. J Natl Cancer Inst 2006; 98: 414-417.

The Journal of the National Cancer Institute is published by Oxford University Press and is not affiliated with the National Cancer Institute.

Wednesday, August 12, 2009

Mouse Model For Mesothelioma Reproduces Human Disease

Scientists have established a mouse model for human malignant mesothelioma that will provide valuable insight into cancer development and progression along with new directions for design of therapeutic strategies. The research, published by Cell Press in the March issue of Cancer Cell, may eventually lead to a substantially improved outlook for patients with this devastating disease.

Malignant mesothelioma is an aggressive cancer originating from the mesothelial lining of the pleural cavity. Malignant mesothelioma is associated with asbestos exposure and is characterized by a long latency period between exposure and disease onset. Chemotherapy can sometimes lead to improvement of overall survival but there is no cure for malignant mesothelioma and patients often succumb from the disease within a year of diagnosis. "There is an urgent need for experimental models of malignant mesothelioma that can be used to not only study the onset and progression of the disease, but also to serve as a model to select new combination therapies and targeted agents," says study leader, Dr. Anton Berns, from The Netherlands Cancer Institute.

In humans, malignant mesothelioma has been associated with genetic lesions that result in the loss of Neurofibromatosis type 2 (NF2) and genetic lesions affecting RB and P53 pathways. Dr. Berns' team investigated whether a range of conditional single or compound mutations in the Nf2, p53 and Rb pathways within the mesothelial lining of the thoracic cavity would cause malignant mesothelioma in mice.

The researchers found that the vast majority of mice with conditional Nf2;Ink4a/Arf and Nf2;p53 mutations developed MM after a short latency period. The mouse malignant mesothelioma tumors, which could be followed noninvasively through the use of bioluminescence imaging, closely resembled human MM. Interestingly, Nf2;Ink4a/Arf knockout mice had a more invasive cancer when compared with Nf2;p53 knockout mice. The researchers went on to show that the loss of Ink4a makes a substantial contribution to the poor clinical outcome of murine malignant mesothelioma .

These results describe an excellent model system for investigating the molecular mechanisms that underlie malignant mesothelioma . "Our mouse models should be suitable to further dissect pathways critically important in mesothelioma development and progression and serve as invaluable tools to test new intervention strategies," concludes Dr. Berns. "We have also derived a series of cell lines that reproduce the disease when grafted into the thoracic cavity. These may also facilitate design of better MM therapies."

The researchers include Johan Jongsma, Erwin van Montfort, Marc Vooijs, John Zevenhoven, Paul Krimpenfort, Martin van der Valk, Marc van de Vijver, and Anton Berns, of The Netherlands Cancer Institute, Amsterdam, The Netherlands.

Journal reference: Berns et al.: "A Conditional Mouse Model for Malignant Mesothelioma". Cancer Cell, Vol 13, 261-271, 11 March 2008.

Monday, August 10, 2009

Mesothelioma: Chemo Combination Improves Survival In Asbestos-related Cancer

People with mesothelioma -- a form of cancer associated with asbestos exposure -- have a higher survival rate when treated with a combination of two cancer drugs, a large multicenter study finds.

Mesothelioma, a rare but aggressive form of cancer that occurs in the lining of the lungs, heart and abdomen, is associated with exposure to asbestos. There is no known cure.

In the study, patients receiving pemetrexed and cisplatin -- along with the vitamin supplements folic acid and B12 -- survived nearly three months longer than patients getting cisplatin alone.

Researchers led by John Green, M.D., at the Clatterbridge Center for Oncology in England, reviewed a study of 448 patients with advanced mesothelioma who were treated with either the single drug or the combination.

"Pemetrexed used in combination with cisplatin significantly increases the length of survival, when compared with cisplatin alone," the researchers say. "Further research is needed into the optimum treatment regimen for pleural mesothelioma."

The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

The researchers examined data from a clinical trial of 20 treatment centers in Europe, the Americas, Australia and Asia. Eighty-one percent of the patients were men, with an average age of 61. Patients who received the combination treatment survived an average 2.8 months longer.

Patients receiving both medications also reported improved quality of life in terms of fatigue, loss of appetite, pain and cough.

During the early stages of the trial, patients receiving pemetrexed had serious symptoms of toxicity, including drug-related death. Other side effects included blood cell abnormalities, nausea and diarrhea, which decreased in both incidence and severity after the vitamins were added to the treatment. People who work trades such as shipbuilding, railway engineering, construction work and asbestos manufacture have higher rates of mesothelioma than the general public. The cancer may take 10 to 60 years to develop, and the risk does not diminish after exposure to asbestos has stopped. Family members of people exposed to asbestos at work also have an increased risk of developing mesothelioma from asbestos fibers carried home on the clothes of the people they live with.

Daniel Baram, M.D., a pulmonologist at the Lung Cancer Evaluation Center at the State University of New York, said, "Most cases [of mesothelioma] are still from pre-OSHA workplace improvements. I suspect that modern asbestos abatement precautions will avoid most, if not all, future cases. The latency is over 30 years, so we are still diagnosing cases with exposure during World War II and the '40s and '50s."

Mesothelioma is difficult to diagnose, Green said, because "there is a lag of many years between exposure and asbestosis, which is a nonmalignant condition, and a greater lag before the development of overt malignancy."

"There is no way of diagnosing the premalignant phase during the latent period of 15 to 20 years," Green added. "Many of these patients smoke and are in economically disadvantaged communities. Many individuals have moved away from heavy industries and may not admit or know they were exposed to asbestos as young men, with similar issues for their partners."

According to the U.S. Environmental Protection Agency, 10 percent to 15 percent of schools and other public buildings in the United States contain asbestos insulation.

Although safety measures for working with asbestos have been in place since the 1970s, mesothelioma is projected to account for 65,000 deaths between 2001 and 2050 worldwide, peaking between 2012 and 2015, according to background information in the review.

It is a personal matter as to whether the survival increase for patients receiving the two drugs is worthwhile, Baram said. "It depends in large part on the patient. A 2.8-month mean survival increase means that some patients may get even more than that, though some people will get less. Many, if not most, patients when faced with a disease with a very bad prognosis are often willing to undergo aggressive therapy, although the toxicity is serious and potentially life-threatening."

Green J, et al. Pemetrexed disodium in combination with cisplatin versus other cytotoxic agents or supportive care for the treatment of malignant pleural mesothelioma. Cochrane Database of Systematic Reviews 2007, Issue 1.

The Cochrane Collaboration is an international nonprofit, independent organization that produces and disseminates systematic reviews of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions. Visit http://www.cochrane.org for more information.

Saturday, August 8, 2009

Gene Expression Ratio Test Predicts Outcome In Mesothelioma Patients Treated With Surgery

ScienceDaily (Apr. 28, 2009) — A four-gene expression ratio test prospectively distinguished mesothelioma patients who had a statistically significant longer overall survival from those who had shorter survival in a single-institution study.

There are few effective treatment options available for patients with malignant pleural mesothelioma other than surgery. However, not all patients appear to derive benefit from surgery. Raphael Bueno, M.D., of the Brigham and Women's Hospital in Boston and colleagues showed in retrospective studies that measuring expression ratios of four genes could distinguish between those who have a good prognosis after surgery and those who have a poor prognosis.

In the current study, Bueno and colleagues tested the four-gene expression ratio test in 120 patients with mesothelioma who were treated at Brigham and Women's Hospital and participated in a prospective clinical trial. To evaluate the robustness and reproducibility of the test, the researchers evaluated the test on multiple tumor samples from each patient and used two different microarray platforms and two different biopsy techniques.

The test was able to predict overall survival after adjusting for other clinical factors. The test results were consistent for individual patients regardless of the techniques used for the test. When the researchers combined the gene ratio test results with known prognostic factors, they were able to separate patients into high-risk and low-risk groups. The median survival for patients in the high-risk group was 6.9 months compared with 31.9 months in the low-risk group.

"Patients whose gene ratio test results predict a good prognosis after surgery may more confidently select the treatment option that includes surgery," the authors write.

This research was published in the Journal of the National Cancer Institute on April 28, 2009.