Mesothelioma from asbestos exposures: Epidemiologic patterns and impact in the United States

Mesothelioma, a rare tumor, is highly correlated with asbestos exposure. Mesothelioma, similar to all asbestos-related diseases, is dose/intensity dependent to some degree, and studies showed the risk of mesothelioma rises with cumulative exposures. Multiple processes occur in an individual before mesothelioma occurs. The impact of mesothelioma in the United States has been continuous over the last half century, claiming between 2,000 and 3,000 lives each year. Mesothelioma is a preventable tumor that is more frequently reported as associated with asbestos exposure among men than women. However, the rate of asbestos-associated mesothelioma is on the rise among women due to better investigation into their histories of asbestos exposure. It is of interest that investigators detected asbestos-associated cases of mesothelioma in women from nonoccupational sources—that is, bystander, incidental, or take-home exposures. It is postulated that asbestos-associated mesotheliomas, in both men and women, are likely underreported. However, with the implementation of the most recent ICD-10 coding system, the correlation of mesothelioma with asbestos exposure is expected to rise to approximately 80% in the United States. This study examined the demographic and etiological nature of asbestos-related mesothelioma.

Source: Mesothelioma from asbestos exposures: Epidemiologic patterns and impact in the United States


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COA finds electrician can sue former employers for mesothelioma diagnosis

The Indiana Court of Appeals held Wednesday that an electrician can sue his former employers for negligence and liability after he was exposed to asbestos.

Larry Myers worked as an electrician for Koontz-Wagner Electric from 1961 to 1980, serving as an independent contract for companies such as Bremen Casting and Mastic Home Exteriors Inc. During his time as an electrician, Myers was not trained or hired to handle asbestos, so he did not wear protective gear, which resulted in his 2014 diagnosis of malignant pleural mesothelioma as a result of asbestos exposure.

Myers subsequently filed a complaint against Bremen, Mastic and nearly 40 other companies, alleging that the defendants negligently hired Myers and were vicariously liable for his diagnosis as principals, and further liable as premises owners. The defendants knew or should have known about the dangers of asbestos, Myers claimed, and should have warned him of those dangers.

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Source: COA finds electrician can sue former employers for mesothelioma diagnosis

 


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Adjuvant Chemotherapy Improves Survival in Diffuse Malignant Peritoneal Mesothelioma

This retrospective study evaluated the effects of perioperative treatment options in 126 patients with diffuse malignant peritoneal mesothelioma (DMPM) undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC). The 5-year overall survival was significantly different among the perioperative treatment groups: 40% in patients receiving neoadjuvant chemotherapy, 67% in patients receiving adjuvant chemotherapy, 62% in patients receiving perioperative chemotherapy, and 56% in patients receiving no chemotherapy before or after CRS-HIPEC. Major complications occurred in approximately 40% of patients in each group. Worse overall survival was significantly associated with receiving neoadjuvant chemotherapy (HR, 2.30; 95% CI, 1.07–4.94; P = .033).

This study suggests that neoadjuvant chemotherapy may decrease overall survival while adjuvant chemotherapy may improve survival in patients with DMPM who undergo CRS-HIPEC.

Source: Adjuvant Chemotherapy Improves Survival in Diffuse Malignant Peritoneal Mesothelioma


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FDA grants fast track designation to galinpepimut-S for malignant plural mesothelioma

The FDA granted fast track designation to galinpepimut-S for the treatment of malignant pleural mesothelioma, according to the drug’s manufacturer.

“This fast track designation underscores the importance of galinpepimut-S as a potential treatment option in mesothelioma … [We] expect the fast track designation to expedite the time to market, thereby enhancing the value proposition of galinpepimut-S in this indication,” Angelos M. Stergiou, MD, vice chairman and CEO of SELLAS Life Sciences Group, said in a press release.

Galinpepimut-S (WT1 cancer vaccine, SELLAS Life Sciences Group) — a late clinical-stage immunotherapy — was evaluated in a randomized, double blind, placebo-controlled phase 2 study that included 40 patients with malignant pleural mesothelioma treated at Memorial Sloan Kettering Cancer Center and The University of Texas MD Anderson Cancer Center.

Results — presented this year at the ASCO Annual Meeting and the International Mesothelioma Interest Group— showed median OS was 24.8 months among patients treated with galinpepimut-S compared with 16.6 months in the control arm. The survival benefit was even greater among patients with a complete tumor resection who were subsequently treated with galinpepimut-S.

Source: FDA grants fast track designation to galinpepimut-S for malignant plural mesothelioma


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Modest Results for Checkpoint Agents in Mesothelioma

Chicago— Two trials presented at the 2016 annual meeting of the American Society of Clinical Oncology (ASCO) provide somewhat discouraging findings on checkpoint inhibitors for second-line treatment of mesothelioma.

In the largest checkpoint inhibitor study in mesothelioma to date, a Phase IB study conducted with the programmed death ligand-1 (PD-L1) inhibitor avelumab (Pfizer), the objective response rate (ORR) among the 53 patients in the study, who had unresectable pleural or peritoneal mesothelioma that had progressed after chemotherapy, was 9.4%, and 47.2% achieved stable disease (abstract 8503). The median progression-free survival was 17.1 weeks, but several responders remain on avelumab and are being followed for long-term benefit, reported Raffit Hassan, MD, the head of the thoracic and solid tumor immunotherapy section of the National Cancer Institute, in Bethesda, Md.

Although the ORR has been closer to 30% in smaller and previously reported studies with the programmed death-1 (PD-1) inhibitors pembrolizumab (Keytruda, Merck) and nivolumab (Opdivo, Bristol-Myers Squibb), the ASCO-invited discussant of the study, Tom John, MBBS, PhD, a senior investigator in thoracic oncology at the Olivia Newton-John Cancer Research Institute, in Melbourne, Australia, suggested the studies have been relatively consistent. “There is a signal for efficacy in mesothelioma, but these studies are also a reality check,” Dr. John reported. With a PD-1 inhibitor monotherapy, “most patients do not seem to benefit.”

Source: Modest Results for Checkpoint Agents in Mesothelioma


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Court rejects $8M verdict in asbestos case

Pointing to problems with expert witnesses, an appeals court Wednesday rejected an $8 million verdict in a case filed by a man who said he suffered mesothelioma because of exposure to asbestos in cigarette filters and in other products.

A panel of the 4th District Court of Appeal ordered a new trial for R.J. Reynolds Tobacco Co. and a “directed” verdict in favor of Crane Co., a manufacturing company.

It ruled against Richard DeLisle, who won the verdict in the Broward County case.

DeLisle alleged that he was exposed to asbestos in filters of Kent cigarettes he smoked in the 1950s.

R.J. Reynolds is a successor company to the manufacturer of Kent cigarettes.

He also alleged exposure in the 1960s in a workplace through sheet gaskets used by Crane Co., a valve and pump manufacturer, the ruling said.

[Article continues at original source]

Source: Court rejects $8M verdict in asbestos case


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Arginine deprivation shows promise for malignant pleural mesothelioma

Arginine deprivation with pegylated arginine deiminase may improve PFS and prolong life expectancy in patients with argininosuccinate synthetase 1–deficient malignant pleural mesothelioma, according to the results of a randomized phase 2 trial.

The incidence of malignant pleural mesothelioma has risen in the United States and in Europe. The disease has a median survival from diagnosis of less than 1 year, and few validated treatment options exist.

“To our knowledge, we were the first to show that an exogenous supply of the amino acid arginine is critical for the survival of mesothelioma cell lines displaying loss of the urea cycle and arginine biosynthetic enzyme argininosuccinate synthetase 1 (ASS1),” Peter W. Szlosarek, MD, PhD, clinical senior lecturer at Barts Cancer Institute and Barts and The London School of Medicine and Dentistry, in London, and colleagues wrote. “Various ASS1–negative tumors have been shown to be sensitive to arginine depleters, mycoplasmal-derived pegylated arginine deiminase (ADI-PEG20, Polaris Group) and recombination human arginases, in preclinical studies.”

[Article continues at ariginal source]

Source: Arginine deprivation shows promise for malignant pleural mesothelioma


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Asbestos and product defence science

In 2015, the Collegium Ramazzini, an independent, international academy of experts in occupational and environmental health, released three statements on asbestos.1–3 The documents are focused on the only form of asbestos remaining in use, i.e. chrysotile (white asbestos). The Collegium is concerned by the persisting use of chrysotile in many countries taking place in spite of the evidence of its carcinogenicity and the calls for a ban by the World Health Organization, the International Labour Organization and the Collegium itself as well as other institutions over the past decades.

Currently, over half of the world’s population is extracting and/or using 2 million tons of asbestos annually, mostly in low- and middle-income countries. Asia has become the largest asbestos consumer in the world and Russia, Kazakhstan and Brazil have become the largest asbestos exporters. As late as 2015, the major producers and users of asbestos opposed the inclusion of chrysotile among substances covered by the Rotterdam Convention on the Prior Informed Consent Procedure for Certain Hazardous Chemicals and Pesticides in International Trade….

The Collegium notes that the reluctance to stop using asbestos is a consequence of ‘the corrupting influence of pro-chrysotile lobbies employing product defence science’. This term encompasses research activities whose goals are not scientific knowledge but to influence policy decisions on the use of an industrial product….

[Article continues at original source]

Source: Asbestos and product defence science

 


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Asbestos exposure and histological subtype of malignant mesothelioma

Abstract

Background   Malignant mesothelioma (MM) has distinct histological subtypes (epithelioid, sarcomatoid and biphasic) with variable behaviour and prognoses. It is well recognised that survival time varies with the histological subtype of MM. It is not known, however, if asbestos exposure characteristics (type of asbestos, degree of exposure) are associated with different histological subtypes.

Aim   To determine if the pathological MM subtype is associated with the type of asbestos or the attributes of asbestos exposure.Methods Cases of MM for the period 1962 until 2012, their main histological subtype and their most significant source of asbestos exposure were collected from the Western Australian Mesothelioma Registry. Exposure characteristics included, degree of asbestos exposure (including total days exposed, years since first exposure and, for crocidolite only, calculated cumulative exposure), source of exposure (occupational or environmental), form of asbestos handled (raw or processed) and type of asbestos (crocidolite only or mixed fibres).

Results   Patients with the biphasic subtype were more likely to have occupational exposure (OR 1.83, 1.12 to 2.85) and exposure to raw fibres (OR 1.58, 1.19 to 2.10). However, differences between subtypes in the proportions with these different exposure characteristics were small and unlikely to be biologically relevant. Other indicators of asbestos exposure were not associated with the histological subtype of mesothelioma.

Conclusions   There was no strong evidence of a consistent role of asbestos exposure indicators in determining the histological subtype of MM.

Source: Asbestos exposure and histological subtype of malignant mesothelioma

 


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Whitley Bay grandad diagnosed with same asbestos-related cancer that killed his dad

A former teacher who watched his own father die of asbestos-related cancer has spoken of his devastation at finding out he has the same disease.

Adrian Starr was diagnosed with the terminal illness, mesothelioma, in October last year and says his only hope now is if medics are able to find a cure.

The 67-year-old, a dad of two and granddad of three, is a retired teacher who worked at various schools across the North East, but believes his exposure to the deadly fibres may date back as far as the 1970s when he worked for one summer at the same paper mill as his father in Kent.

Adrian, from Whitley Bay, said: “I was only there for a short period, but that is where my father was exposed to asbestos dust.

“He was a maintenance engineer and worked in dirty, dusty areas where pipes lagged with asbestos ran across the ceiling and underneath the floor.

“I worked in a different area, but I remember often having tea from a flask we’d brought from home sitting with my dad at his end of the factory.

“I don’t know whether the damage was done there or at one of the schools where I worked.”

[Article continues at original source]

Source: Whitley Bay grandad diagnosed with same asbestos-related cancer that killed his dad

 


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