California Asbestos Law Blog

Researchers are studying whether chemotherapy before surgery and radiation can deter tumor recurrence in patients with mesothelioma, a rare cancer of the lining of the chest caused by asbestos exposure.

The study builds on the success of a previous clinical trial at M. D. Anderson that included surgery called extra pleural pneumonectomy (EPP), which involves removal of the affected lung and lining of the chest, followed by a highly specialized form of radiation therapy known as Intensity Modulated Radiotherapy (IMRT).

The new multi-center study, which will recruit 77 patients nationwide, will involve EPP, post-operative IMRT and the chemotherapy drugs pemetrexed (Alimta®) and cisplatin, says Katherine Pisters, M.D., principal investigator on the study at M. D. Anderson and associate professor in the Department of Thoracic/Head and Neck Medical Oncology.

Treatment Options for Malignant Mesothelioma
Localized Malignant Mesothelioma (Stage I)

If the malignant mesothelioma is in one part of the chest lining, treatment will probably be surgery to remove the part of the chest lining with cancer and some of the tissue around it.

If localized malignant mesothelioma is found in more than one place in the chest, treatment may be one of the following:

Pleurectomy and decortication, with or without radiation therapy, as palliative therapy to relieve symptoms and improve the quality of life.
Extrapleural pneumonectomy.
Radiation therapy as palliative therapy to relieve symptoms and improve the quality of life.
A clinical trial of anticancer drugs placed directly into the chest after surgery to remove the tumor.
A clinical trial of combinations of surgery, radiation therapy, and chemotherapy.
A clinical trial of a new treatment.

Implantable Device May Offer Better Pain Management
National Cancer Institute

Patients with advanced cancer who used an implantable drug-delivery device to control their pain had better pain relief, fewer toxic side effects, and better survival than patients who received intensive medical pain management, researchers reported in the October 1, 2002, issue of the Journal of Clinical Oncology.

The multicenter trial involved 202 patients who were randomly assigned to two groups. One group received comprehensive medical management (CMM) for their pain. CMM is a more systematic approach to pain control than cancer patients typically receive. It involves a team of health care professionals with special training in pain management who search for the most effective pain medication for each patient by starting with the least toxic and only gradually moving up to medications with more side effects until the pain is relieved. CMM may also include the use of complementary methods of pain reduction such as relaxation, guided imagery, psychotherapy, and patient support groups.

Treatment for mesothelioma depends on the location of the cancer, the stage of the disease, and the patient's age and general health. Standard treatment options include surgery, radiation therapy, and chemotherapy. Sometimes, these treatments are combined.

Case-Control Study of Cancer among US Army Veterans Exposed to Simian Virus 40-contaminated Adenovirus Vaccine

Dana E. M. Rollison1, William F. Page2, Harriet Crawford2, Gloria Gridley3, Sholom Wacholder3, Jennifer Martin4, Richard Miller2 and Eric A. Engels3
1 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
2 Medical Follow-up Agency, Institute of Medicine, the National Academies, Washington, DC.
3 Division of Cancer Epidemiology and Genetics, National Cancer Institute, Department of Health and Human Services, Rockville, MD.
4 RTI International, Rockville, MD.

Simian virus 40 (SV40) was an accidental contaminant of vaccines produced in monkey kidney tissue cultures in the 1950s and early 1960s, including a parenteral adenovirus vaccine given to several hundred thousand US military recruits. Detection of SV40 DNA in tumor tissues by some laboratories suggests that SV40 contributes to human cancers. To determine if entry into US Army service during periods of administration of SV40-contaminated adenovirus vaccine was associated with an increased risk of cancer, the authors conducted a case-control study of cancer occurring in male Army veterans who entered service in 1959-1961.

Largest-Yet Mesothelioma Study Shows Survival Benefit with New Drug

Key Words: chemotherapy, lung cancer, mesothelioma, pemetrexed. (Definitions of many terms related to cancer can be found in the Cancer.gov Dictionary.)

Researchers with the largest phase III trial to date for mesothelioma, an aggressive cancer affecting the lining of the lung, reported results showing that patients on a new chemotherapy drug regimen live longer and have less pain than those on an older drug. The findings were announced at the annual meeting of the American Society of Clinical Oncology meeting in Orlando, Fla., on May 20, 2002. (NOTE: The final data were subsequently published in the July 15, 2003, issue of the Journal of Clinical Oncology; see the journal abstract).

BACKGROUND: Surgical resection of malignant pleural mesothelioma is reported to have up to an 80% rate of local recurrence. We performed a phase II trial of high-dose hemithoracic radiation after complete resection to determine feasibility and to estimate rates of local recurrence and survival. METHODS: Patients were eligible if they had a resectable tumor, as determined by computed tomographic scanning, and adequate cardiopulmonary function for extrapleural pneumonectomy or pleurectomy/decortication. After complete resection, patients received hemithoracic radiation (54 Gy) and then were followed up with serial computed tomographic scanning.

Journal of Clinical Oncology, Vol 21, Issue 14 (July), 2003: 2636-2644
© 2003 American Society for Clinical Oncology

Phase III Study of Pemetrexed in Combination With Cisplatin Versus Cisplatin Alone in Patients With Malignant Pleural Mesothelioma

Nicholas J. Vogelzang, James J. Rusthoven, James Symanowski, Claude Denham, E. Kaukel, Pierre Ruffie, Ulrich Gatzemeier, Michael Boyer, Salih Emri, Christian Manegold, Clet Niyikiza, Paolo Paoletti

From the University of Chicago Cancer Research Center, Chicago, IL; Eli Lilly and Company, Indianapolis, IN; US Oncology, Dallas, TX; Allgemeines Krankenhaus Harburg, Hamburg; Krankenhaus Gro?ühansdorf, Gro?ühansdorf; and Thoraxklinik-Rohrbach, Heidelberg, Germany; Institut Gustave Roussy, Villejuif, France; Royal Prince Alfred Hospital, Camperdown, Australia; and Hacettepe University Medical Faculty, Ankara, Turkey.

Updated Analysis in Second-Line Treatment of Lung Cancer Trial Confirms Similar Survival for Alimta(R) and Docetaxel

Sunday June 4, 8:00 am ET
Alimta Also Shows Tolerability as Triplet Combination Treatment in First-Line Lung Cancer

ATLANTA, Data presented today at the 42nd American Society of Clinical Oncology (ASCO) annual meeting in Atlanta, Ga., affirms that ALIMTA® (pemetrexed), manufactured and marketed by Eli Lilly and Company, offers patients with advanced non-small cell lung cancer (NSCLC) similar overall survival as docetaxel (Taxotere®).

LOS ANGELES, June 8 /PRNewswire/ -- Terry McCann, Olympic gold
medalist, Toastmaster CEO, and asbestos victims rights advocate, died
yesterday from malignant mesothelioma. As a wrestler, surfer,
environmentalist, coach, devoted father, and spokesman for asbestos cancer
patients, Mr. McCann dedicated his life to serving others. He was also a
director on The Pacific Heart Lung & Blood Institute (http://www.phlbi.org ), a
medical research foundation in Los Angeles.
"We mourn the loss of a giant," said Roger Worthington, a director on
PHLBI. "Terry was one of the toughest men I have ever known, with a heart
of pure gold. In his final days, Terry's only concern was for his family,
his friends, and other mesothelioma patients."