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Update from Mesothelioma Information
This last installment from our two part aricle from the extracts of the Program Report of the International Mesothelioma Program details more of the IMPs major areas of research . . .
Genomics: Diagnosis and Prognosis
Raphael Buena, MD
Principal Investigator
The most effective current therapy for mesothelioma is extrapleural pneumonectomy (EPP) followed by chemotherapy and radiation therapy. Yet only some patients benefit from this aggressive, often grueling, treatment approach. Leaders of this project have developed a new gene ratio-based test to identify, prior to surgery, those patients who are most likely to benefit from multimodality therapy. Researchers currently are conducting a prospective study to validate and confirm the accuracy of this prognostic test in a series of patients undergoing trimodality therapy.
To make the process of mesothelioma diagnosis and prognosis easier, researchers also have developed a methodology for obtaining patient specimens using ultrasound-directed fine-needle biopsy. A second clinical trial currently is under way to evaluate the efficacy of this approach in diagnosing and predicting outcome in mesothelioma patients.
Therapeutic Targets in Mesothelioma
Jonathan A. Fletcher, MD
Principal Investigator
Because very few patients with malignant mesothelioma do well with conventional chemotherapies, there is an urgent need for more effective systemic therapies. Leaders of this project will evaluate activated tyrosine kinase proteins as possible new therapies.
Tyrosine kinases play key roles in the development of many cancers. These kinases can be thought of as light switches that are stuck in the "ON" mode, and that continuously send signals to the mesothelioma cells, telling them to grow. The correct drug can turn these kinase switches off, causing the mesothelioma cells to stop growing and die. Previous work by this group has identified several activated kinases in mesothelioma, including one called "AXL" and they now are studying exactly how these kinases cause normal mesothelial cells to become cancerous. These studies will enable rapid advances in mesothelioma treatment by characterizing kinases that are abnormally activated and by evaluating clinical regimens designed to inactivate them.
Clinical Trials and Novel Therapies
David J. Sugarbaker, MD
Principal Investigator
Malignant pleural mesothelioma is unique among cancers in its tendency to spread locally and regionally, invading adjacent structures before it spreads systemically. The biology of the disease is not well understood, and there are very few treatment options. The overall goal of this project is to organize the research component of the clinical management of patients in the IMP. The backbone of this project is conducting therapeutic clinical trials that focus on further studying the role of high dose, intraoperative, intracavitary heated chemotherapy as a way to optimize control of local disease spread. This approach has shown promise in preliminary work.
This project is closely integrated with the IMP's other projects. It supplies patient data and biological specimens to the epidemiology and basic science projects, and provides the clinical trials infrastructure to support the evaluation of new therapeutic agents as they are identified. This project also aims to better understand the impact of mesothelioma on patients' and caregivers' quality of life in relation to the course of the disease and treatment they receive. A goal is to develop clinical guidelines to optimize the survival and quality of life of patients through the appropriate matching of patients with specific therapies.
Previous update from Mesothelioma Information
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