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Journal Articles on Mesothelioma: Cancer Information for Patients and Families

Archive for the 'Determining Efficacy' Category

Studies which measure or otherwise analyze the effectiveness of various treatments and the methods used to generate the information from which efficacy is determined (for instance, is MRI an effective method to measure chemotherapy results).

Determining Efficacy news feed.

January 2nd, 2009. Phase I and Pharmacokinetic Study of Pemetrexed plus Cisplatin in Chemonaive Patients with Locally Advanced or Metastatic Malignant Pleural Mesothelioma or Non–Small Cell Lung Cancer

Conclusions: Pemetrexed with vitamin supplementation was safe and well tolerated at higher doses than the currently established 500 mg/m2 + 75 mg/m2 cisplatin. Based on this study, the recommended dose would be 800 mg/m2 pemetrexed + 75 mg/m2 cisplatin. However, recent studies showed a lack of improved efficacy for 900 or 1,000 mg/m2 single-agent pemetrexed versus 500 mg/m2 and a lack of PK/pharmacodynamic exposure-response relationship for the pemetrexed/cisplatin combination across pemetrexed exposures corresponding to this dose range. Based on currently available evidence, we recommend retaining the established dose.

December 25th, 2008. Peritoneal mesothelioma: treatment with cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy

Conclusion: Cytoreductive surgery combined with HIPEC may improve the length of survival for patients with diffuse malignant peritoneal mesothelioma; such patients should be treated in specialized centers.

December 19th, 2008. Gemcitabine combined with oxaliplatin in pretreated patients with malignant pleural mesothelioma: an observational study

Conclusion: Pemetrexed-pretreated patients with progressive MPM may benefit from a consecutive chemotherapy with oxaliplatin and gemcitabine without significant toxicity.

December 18th, 2008. Medical thoracoscopic talc pleurodesis for malignant pleural effusion: an analysis of 27 cases

Conclusion: Medical thoracoscopic talc poudrage pleurodesis is a safe and effective method for the treatment of malignant pleural effusion.

December 17th, 2008. Diffuse Malignant Peritoneal Mesothelioma: Failure Analysis Following Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

We conclude that minimal residual disease, compared with macroscopically complete cytoreduction, correlated to failure in critical anatomical areas, suggesting the need for maximal cytoreductive surgical efforts. In selected patients, aggressive management of progressive disease seems worthwhile.

December 2nd, 2008. Malignant peritoneal mesothelioma-Results from the International Expanded Access Program using pemetrexed alone or in combination with a platinum agent

Results: Response rates (95% CI) for PEM, PEM/CIS, and PEM/CARBO were 12.5% (3.5, 29.0), 20.0% (7.7, 38.6), and 24.1% (10.3, 43.5), respectively. Median survival for PEM was 10.3 months. One-year survival rates for PEM/CIS and PEM were 57.4% (95% CI: 10.3, 100) and 41.5% (95% CI: 4.6, 78.4), respectively, and were not available for PEM/CARBO. Anemia was the most common serious adverse event (6.4%). Neutropenia (34.6%) was the most frequent CTC grade 3 or 4 toxicity reported. Concluding statement: PEM with or without a platinum agent was both active and well tolerated in patients with peritoneal mesothelioma.

December 2nd, 2008. Monitoring of Chemotherapy Response in Malignant Pleural Mesothelioma Using Fluorodeoxyglucose Positron Emission Tomography

The tumor lesion exhibited shrinkage on CT and a decrease in the standardized uptake value (SUV) max after the first course of chemotherapy, but exhibited size enlargement and an increase in SUV max after the second course of chemotherapy. These findings suggest that results of quantification of metabolic response by FDG-PET are related to the objective response as determined by CT in patients with MPM.

November 28th, 2008. Biomarkers for malignant pleural mesothelioma: current status

Future research efforts should focus on biomarkers predictive of the efficacy and toxicity of standard chemotherapy. Translational research should be systematically incorporated into the design of clinical trials assessing new targeted agents in MPM.

November 26th, 2008. Comparison of semiquantitative fluorescence imaging and PET tracer uptake in mesothelioma models as a monitoring system for growth and therapeutic effects

Conclusion: Fluorescence imaging could be used to semiquantitatively monitor tumor size, whereas PET could be used to monitor tumor response to therapeutic treatments, and especially, FLT might be a good marker of the response to anti-folate chemotherapeutics.

November 21st, 2008. Compensator-based intensity-modulated radiation therapy for malignant pleural mesothelioma post extrapleural pneumonectomy

Not all linear accelerators can deliver large-field MLC-based IMRT, but most can deliver a maximum conformal field of 40 x 40 cm. It is possible and reasonable to deliver IMRT with compensators for fields this size with most conventional linear accelerators.

November 20th, 2008. Yang XJ, Li Y, al-shammaa Hassan AH, Yang GL, Liu SY, Lu YL, Zhang JW, Yonemura Y. Department of Oncology, Zhongnan Hospital, Cancer Center of Wuhan University, Hubei Cancer Clinical Study Center, Wuchang District, China.

Eleven patients died, three survived with tumor, and seven survived free of tumor. CRS + HIPEC was well tolerated in our selected patients with PC, some of whom had improved survival.

November 14th, 2008. Outcomes with first-line platinum-based combination chemotherapy for malignant pleural mesothelioma: a review of practice in British Columbia

No difference is seen combining platinum analogs with gemcitabine or pemetrexed. Platinum-based doublets might represent a therapeutic ceiling for cytotoxic chemotherapy in MPM.

November 11th, 2008. Novel and existing mutations in the tyrosine kinase domain of the epidermal growth factor receptor are predictors of optimal resectability in malignant peritoneal mesothelioma

With longer follow-up, mut+ may not only be predictive of survival but may represent a subset of patients whose disease may be responsive to TK-inhibitor therapy. Experiments confirming the activating properties of the novel mutations are warranted.

November 5th, 2008. Case of malignant mesothelioma presenting as a perineal and intrascrotal mass

The patient died six months after the initiation of therapy. To our knowledge, 24 cases of malignant mesothelioma in the perineum or intrascrotum were reported in Japan and this case was thought to be the 25th case in Japan.

November 5th, 2008. Cytoreductive surgery and intraperitoneal chemotherapy for peritoneal mesothelioma

Conclusions: Cytoreductive surgery combined with intraperitoneal chemotherapy appears to be the optimal treatment for selected patients with peritoneal mesothelioma. Increased familiarity with this condition's presentation and natural history, and knowledge of available treatment options, will hopefully facilitate treatment of these patients and expedite speedy referral to appropriate treatment centres.

November 5th, 2008. Treatment of malignant pleural mesothelioma with carboplatin, liposomized doxorubicin, and gemcitabine: a phase II study

Conclusion: The treatment yields good results with a high number of responses and long survival, and a low toxicity. The long survival of the epitheloid subgroup with good prognostic factors is as good as or even better than some studies on radical surgery or multimodal treatment, underlining the need of randomized studies to evaluate such treatment options.

October 23rd, 2008. Malignant abdominal mesothelioma: defining the role of surgery

Conclusion: Surgical extirpation of MAM may be associated with significantly improved survival. All patients with MAM should be evaluated for potential surgical resection.

October 22nd, 2008. Interaction of onconase with the human ribonuclease inhibitor protein

This inhibition occurs with Ki = 0. 15 μM in a solution of low salt concentration.

October 18th, 2008. Carboplatin and pemetrexed in the management of malignant pleural mesothelioma: A realistic treatment option?

Conclusion: The combination of carboplatin and pemetrexed may be a viable option in the treatment of malignant pleural mesothelioma.

October 18th, 2008. The cytotoxic ribonuclease onconase targets RNA interference (siRNA)

The data thus provide evidence that one of the targets of Onc is siRNA, likely within the RNA-induced silencing complex (RISC). In light of the findings that microRNAs are involved in tumor pathogenesis as well as in enhancing cell resistance to anticancer therapy the present data may provide explanation for both, the antitumor Onc activity and its propensity to enhance effectiveness of cytotoxic drugs.