August 2014 Report About Clinical Trial Options That Memorial Sloan Kettering Cancer Center Offers For Patients With Pleural Mesothelioma

This August 7, 2014 article, “Clinical Trial Roster Shows Breadth of Ongoing Research”, gives us an idea about the current state-of-the-art as regards various new malignant mesothelioma treatments, at least those being pursued be the Mesothelioma Program at Memorial Sloan Kettering Cancer Center, in New York.

From that article, by Lee M. Krug, MD, a thoracic oncologist and Director of the Mesothelioma Program:

At Memorial Sloan Kettering, we offer a variety of clinical trials for patients with mesothelioma at all stages of their disease. These trials focus on a range of topics, from looking for genetic factors that predispose people to mesothelioma to exploring ways to combine chemotherapy, surgery, and radiation to optimize outcomes. We also have studies investigating novel therapeutic options.

This article includes discussions about and identifies some clinical studies concerning:

  • Genetic Studies
  • Surgery and Early-Stage Disease
  • Systemic Treatments

At the end of this article there is a diagram of what is currently going on at Memorial Sloan Kettering Cancer Center as regards malignant pleural mesothelioma (MPM) treatments related clinical trial options.


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July 2014: Texas Supreme Court Expands Substantial-Factor Standard Of Causation Rule From Borg-Warner Corp. v. Flores To Mesothelioma Cases

In mid-July 2014, in the case Bostic v. Georgia-Pacific Corp., the Texas Supreme Court held that the Plaintiff failed to prove that Timothy Bostic’s exposure to Georgia-Pacific’s asbestos-containing products was a substantial factor in bringing about his fatal mesothelioma.

In more detail, the Court stated:

  • In multiple-exposure cases the Plaintiff must establish the measured “dose” of asbestos fibers to which the mesothelioma victim was exposed by his working with and/or around the Defendant’s asbestos-containing product;
  • A Plaintiff cannot prove substantial-factor standard of causation without presenting expert testimony that the mesothelioma victim’s exposure to the Defendant’s asbestos-containing product more than doubled the mesothelioma victim’s risk of contracting that asbestos cancer; and,
  • In this Bostic case the Plaintiff’s expert could not conclude that the mesothelioma victim would not have developed his asbestos cancer absent exposure to the Defendant’s asbestos-containing product.

Put otherwise, the Texas Supreme Court expressly rejected the Plaintiff’s “each and every exposure” theory, under which each exposure to asbestos fibers causes or potentially causes the mesothelioma asbestos cancer.

Rather, essentially, this is now the law in Texas for all asbestos cases involving multiple sources of exposure, including mesothelioma cases:

The Plaintiff must present Defendant-specific evidence of the approximate measured dose to which the mesothelioma victim was exposed, and present evidence that the asbestos dose was a substantial factor in causing the asbestos cancer.


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Asbestos Defendant Garlock Misled Court During Bankruptcy Estimation Trial According To June 2014 Motion Filed By Asbestos Claimants’ Counsel

In early January 2014 Judge George R. Hodges of the U.S. Bankruptcy Court for the Western District of North Carolina made a controversial ruling that Garlock Sealing Technologies LLC’s liability for present and future asbestos-mesothelioma legal claims is $125 million.  This was far less than the $1 billion that had been asserted by the asbestos claimants’ counsel during the proceeding. In re Garlock Sealing Techs., No. 10-31607 (Bankr. W.D.N.C. Jan. 10, 2014)

Last month, however, lawyers for those asbestos claimants filed a motion to reopen that so-called “bankruptcy estimation trial” because it produced an estimation order which is “tainted”.  Essentially, their contention is that Garlock “has committed a fraud upon the court” by means of false testimony and the manipulation of critical evidence in this asbestos bankruptcy proceeding.

From the MEMORANDUM IN SUPPORT OF MOTION OF THE OFFICIAL COMMITTEE OF ASBESTOS PERSONAL INJURY CLAIMANTS TO REOPEN THE RECORD OF THE ESTIMATION PROCEEDING (63-page PDF document) filed June 4, 2014, at the start of the Introduction section:

Garlock has misled this Court.  It has invited this Court to conclude, based on incomplete disclosures, misstatements and gross generalizations, that, in every case that mattered, it was the victim of improper withholding of evidence by plaintiffs’ lawyers, and that if only they had been honest, Garlock could not have been found liable for killing people with its asbestos-containing products and would have settled virtually all cases for nuisance value.

Of course, Garlock’s counsel will be filing a brief in opposition to this  asbestos claimants’ motion to reopen, and that should make for some more “interesting” reading as this Garlock asbestos-mesothelioma bankruptcy saga continues.


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“No Safe Use”: A Tremendous Piece Of Interactive Journalism About The Terrible Asbestos-Mesothelioma Problem

I highly recommend that anyone with an interest in learning more about asbestos and asbestos-related diseases — the tragic asbestos cancer mesothelioma in particular — take some time to visit this site: “No Safe Use” (Copyright 2014 The Globe and Mail Inc. All Rights).

It starts with a haunting picture of John Nolan, age 67, blinking his eyes, and this interactive site allows you the option of listening to Mr. Nolan tell the story of his battle with mesothelioma, a cancer caused by exposure to asbestos.

Thereafter, you will find this seven-part journalistic report about the current asbestos problem in Canada with each part presenting some additional powerful photographs related to this terrible situation.

  • Part 1:   The Invisible Epidemic (which tell us more about the above-mentioned John Nolan)
  • Part 2:   Exposure Is Still Widespread
  • Part 3:   The Boom Years
  • Part 4:   Six Months To Live
  • Part 5:   Officially Safe In Canada
  • Part 6:   What Can Be Done
  • Part 7:   “Stuck In This Body”

From this tremendous piece of work, we leave you with a child’s note:

asbestos-note-by-child


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Medical Journal Article About The Clinical, Radiologic, And Pathologic Characteristics Of Asbestos-Related Disease Asbestosis

When asbestos dust or fibers cause scarring of the lungs, also called fibrosis, then the diagnosis will typically be asbestosis.

Although published back in 2002, this article from the RadioGraphics medical journal article, “Asbestos: When the Dust Settles—An Imaging Review of Asbestos-related Disease”, still provides a good overview of the clinical, radiologic, and pathologic characteristics of asbestosis.

From that article, which includes 14 radiology images concerning the asbestosis diagnosis process:

  • Asbestosis is the term given to lung fibrosis caused by asbestos dusts, which may or may not be associated with pleural fibrosis . There is a dose-response relationship between exposure and severity of fibrosis . The lag between exposure and onset of symptoms is usually 20 years or longer (sometimes more than 40 years) but can be as little as 3 years in cases with constant heavy exposure.
  • The changes of asbestosis are more pronounced in the lower lobes and subpleurally but often extend to involve the middle lobe and lingula. Upper lobes can be involved in advanced cases. Honeycombing, as in other fibrotic lung diseases, can occur in advanced disease but is not, however, present in the majority….
  • Features on chest radiographs include ground-glass opacification, small nodular opacities, “shaggy” cardiac silhouette, and ill-defined diaphragmatic contours. Honeycombing and volume loss are seen in more advanced disease.
  • CT, especially high-resolution CT, is more sensitive than plain radiography in depicting asbestosis.
  • The main differential diagnosis both radiologically and histopathologically is usual interstitial pneumonitis or idiopathic pulmonary fibrosis.

[Footnotes and references to associated images omitted.]

Some other non-malignant asbestos-related conditions that are less serious than asbestosis include pleural plaques and pleural thickening.

The asbestos-related cancers are malignant mesothelioma and bronchogenic carcinoma such as lung cancer.

This RadioGraphics medical journal article has discussions of and radiology images for those asbestos-related diseases, also.


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Penn Medical School Will Study Cluster Of Mesothelioma Cases In Ambler, PA, The Site Of A Long-Closed Asbestos Factory

The Penn Superfund Research and Training Program (SRP) Center has been established due to a $10 million grant from the National Institute for Environmental Health Sciences (NIEHS).

This grant will be used over the next four years to study:

  • asbestos exposure pathways that lead to mesothelioma;
  • the bioremediation of this hazardous material; and,
  • mechanisms that lead to asbestos-related diseases.

In more detail, from this June 9, 2014 press release, “Penn receives $10 million award to study asbestos adverse health effects, remediation”:

This award is the first NIEHS Superfund grant driven by problems identified in a community-academic partnership…. The communities of West and South Ambler have long been active in studying the ramifications of their town’s long-closed asbestos factory. Residents in these communities remain at risk for environmental exposure and a potentially increased risk of developing mesothelioma….

From the late 1880s through the present day, Ambler residents have had either occupational or environmental exposure to asbestos. As a result, both current and former residents of the area face potentially serious long-term health consequences….

The new [SRP] Center will tackle two inter-related environmental science studies and four biomedical science studies. The six projects were designed to address a community-based question or concern that been previously identified by the [Community Outreach and Engagement Core (COEC), which is part of the Center of Excellence in Environmental Toxicology (CEET), at the Perelman School of Medicine at the University of Pennsylvania]:

•Can we remediate asbestos without moving it from the original disposal site?

•What do we know about the fate and transport of asbestos in the environment by water and air?

•What do we know about the exposure pathways that were responsible for the mesothelioma cluster in Ambler? And why is the incidence higher in women?

•Is susceptibility to mesothelioma genetic?

•Can asbestos-related disease be prevented?

This sounds like a very interesting and worthwhile study regarding the various facets of the asbestos-mesothelioma public health issue.


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How Lung Cancer Cases Might Qualify For Asbestos Claims Compensation (And Why Smoking Does Not Serve To Disqualify)

It is not widely known the smoking lung cancer claims can get legal compensation payments from many asbestos bankruptcy trust funds if certain criteria are satisfied by the facts.

This article will discuss how a person with lung cancer who has had some asbestos exposure in the past could possibly obtain payments by one or more of the asbestos bankruptcy trusts despite having a smoking history.

As background, many companies have been forced into bankruptcy as a result of significant asbestos litigation costs and have reorganized under Section 524(g) of the U.S. Bankruptcy Code. These corporate reorganizations under 524(g) often involve the creation of personal injury trusts intended to make payments to individuals with qualifying asbestos-related claims, including people with lung cancer who had asbestos exposure and who smoked, also.

These 524(g) asbestos bankruptcy trusts typically provide two processes under which a claim can be qualified and paid. The first process is often referred to as “Expedited Review”. The second process offered by many asbestos trusts in an “Individual Review” option.

The Expedited Review payment criteria for lung cancer claims for most asbestos bankruptcy trusts can be reduced to the following four points:

(1) Primary lung cancer plus underlying bilateral asbestos-related non-malignant disease, which can be: asbestosis (interstitial fibrosis caused by asbestos); pleural plaques; pleural thickening; or, pleural calcification.

(2) Six months of asbestos-containing product exposure, which can range from working with or around: thermal insulation such as pipe covering; industrial / institutional boilers; and, finishing cement or joint compound.

(3) Five years of “Significant Occupational Exposure”, the definition of which may include 20 industries as well as nearly 2,000 combinations of industries and occupations where asbestos exposure was likely.

(4) A medical causation statement by a treating doctor or an expert retained by a lawyer.

Notably, for an Expedited Review lung cancer claim there is no smoking history disclosure requirement.

Moving to the Individual Review process — which allows for a higher payment to the claimant — for the lung cancer category the claimant is considered to be a “non-smoker” if the person has at least 12-years of smoking cessation prior to the lung cancer diagnosis date.

In summary, a person with lung cancer who has a minimum of bilateral pleural thickening plus five-years occupational exposure in one of the 2,000 industries – occupations combinations could possibly qualify for a legal claim payment from an asbestos bankruptcy trust fund.

To the extent that you or someone you know has a possible smoking lung cancer asbestos case that might fit the bankruptcy claims criteria set forth above, we encourage you to contact us or some other experienced asbestos law firm for a free evaluation of the matter.


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For Malignant Pleural Mesothelioma The Identification Of Molecular Profiles Is Helpful In Selecting Targeted Therapies

A relatively new medical journal article reports on a development which may improve survival time for those men and women who, unfortunately, have developed malignant pleural mesothelioma (MPM).

From the Abstract for a 2014 Clinical Cancer Research article, “Molecular Classification of Malignant Pleural Mesothelioma: Identification of a Poor Prognosis Subgroup Linked to the Epithelial-to-Mesenchymal Transition”, we get this basic information about the results of a recent medical study:

  • Purpose: Despite research efforts to develop more effective diagnostic and therapeutic approaches, malignant pleural mesothelioma (MPM) prognosis remains poor. The assessment of tumor response to therapy can be improved by a deeper phenotypical classification of the tumor, with emphasis on its clinico-biological heterogeneity. The identification of molecular profiles is a powerful approach to better define MPM subclasses and targeted therapies.
  • Conclusions: A robust classification of MPM that defines two subgroups of epithelioid MPM, characterized by different molecular profiles, gene alterations, and survival outcomes, was established.

We will watch for further developments in this avenue of medical research concerning malignant pleural mesothelioma.


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Progression Of Malignant Pleural Mesothelioma Might Be Slowed Down By Systemic Delivery Of Stem Cells

New medical research out of the United Kingdom (UK) suggests using stem cell therapy to decrease tumor burden as a new possible treatment of malignant pleural mesothelioma.

From a March 19, 2014 news report, “Systemic stem cell therapy reduces malignant mesothelioma growth”:

Systemic delivery of stem cells expressing an apoptosis-inducing protein can successfully incorporate into malignant pleural mesothelioma (MPM) cells and subsequently induce their death, according to preclinical study findings….

“Bone marrow-derived mesenchymal stem cells (MSCs) are attractive candidates as vectors for anticancer therapies for a variety of reasons,” say Sam Janes (University College London, UK) and colleagues who performed the study….

“In this study, we show for the first time that MSCs expressing TRAIL (MSCTRAIL) induce apoptosis in MPM cells in vitro,” Janes and team report in Thorax. TRAIL, or tumour necrosis factor-related apoptosis-inducing ligand, is a transmembrane protein and an “exciting anticancer molecule”, the team explains….

“MSCs home to and incorporate into tumours in vivo when delivered via both intrapleural and intravenous routes,” the team notes, so using these cells to deliver TRAIL is an interesting prospect for malignant mesothelioma, which is often too diffuse to surgically remove or does not respond well to chemotherapy.

We will continue to watch for more developments as regards the use of certain stem cells to reduce the growth of malignant pleural mesothelioma (MPM) cells.


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Baltimore Judge Refuses A Proposed Plan For The Trial Consolidation Of More Than 13,000 Non-Mesothelioma Asbestos Cases

Back in the early 1990s I was part of a trial team at the Ness Motley law firm who represented thousands of former workers from the Ingalls Shipyard (Pascagoula, Mississippi) in one very large asbestos trial. It was so large, in fact, that it had to be held in a makeshift courtroom over at the county fairgrounds because the local state courthouse did not have sufficient room for all the attorneys involved with this trial, which lasted about six months.

There has not been any mass trial consolidations for asbestos cases in many years. However, recently the Circuit Court for Baltimore City — a court with one of the largest number of total pending asbestos cases in the US — was asked by an asbestos plaintiffs’ law firm in Baltimore to consolidate more than 13,000 non-mesothelioma cases into a three-phase consolidated trial process.

On March 5, 2014, in a 43-page opinion, Judge John M. Glynn rejected this so-called Baltimore “Consolidation III” proposal. See In re Asbestos Pers. Injury, No. 24-X-87-048500, 2014 WL 895441 (Md. Cir. Ct. Mar. 5, 2014).

Consolidating asbestos cases in a mass trial was a common approach two decades ago, but it has since been abandoned by US courts for various reasons.

The March 2014 Order issued by Judge Glynn in Maryland makes it likely that courts will refuse to approve any other asbestos case consolidations which may be proposed, or not, in the future.


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