Evaluation of asbestos-exposure, clinical diagnosis and treatment of MPM

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Evaluation of asbestos-exposure, clinical diagnosis and treatment of MPM"

Transcription

1 Evaluation of asbestos-exposure, clinical diagnosis and treatment of MPM Aija Knuuttila, MD, PhD Dept. of Pulmonary Medicine Helsinki University Central Hospital, Finland

2 Malignant pleural mesothelioma new cases yearly in Finland! yearly diagnosed /referred to Helsinki Univ. Hospital 80-90% have an occupational asbestos-exposure clinical presentation unilateral pleural effusion in 80-90% chest pain in! 70% dyspnoe in! 60% weight loss, fatigue, fever, CRP " metastases rare, occur late, rarely clinical morbidity median survival after dg: 9-12mos (6 17) 2yr survival! 20% (Herndon et al. 1998, Boutin et al. 1998)

3 Evaluation of asbestos-exposure in MPM any amount of occupational exposure > 10 yrs earlier # occupational disease entitled to compensation risk occupations (ship yard industry, plummers, electricians, mechanicians etc) occupational history - surveyed in detail with a social worker medical statement for the insurance company (employer s) all the treatment given is paid by the insurance company no additional examinations required (eg. BAL, tissue samples) to prove the exposure if accepted cepted/suspected occupational disease post-mortem forensic autopsy required

4 Clinical presentation of MPM

5 Radiological diagnostics chest X-ray diagnosis of pleural effusion, in clinical follow- up (amount of the effusion) CT (chest-abdomen) sometimes pleural effusion only, diffuse pleural tumours, thickening of interlobar fissures in 80%, pleural plaques as marker of asbestos-exposure MRI shows the local invasive growth, demonstration of diaphragmatic growth if radical surgery considered PET-CT large number of MPMs are FDG-PET positive, exclusion of metastases if surgery considered, the role in defining the local invasion still open

6 Growth pattern of MPM originates from parietal pleura, grows platelike over the lung surfaces and lobes, tracks along interlobar fissures, encases the lung - affision of contralat. lung and/or peritoneum! 10-20%

7 The role of serum markers in diagnostics not yet used; ; histological samples needed! S-CA125 sometimes positive (eg. pleural metastases of ovarian ca) in follow-up? S-osteopontin (Pass et al. NEJM 2005) upregulated by asbestos- exposure, does not correlate to stage or to histology S-mesotelin (Pf-mesotelin) (SMRP-soluble mesothelin related peptides) Mesomark (Robinson et al. Lancet 2003) - surface glycoprotein of mesothelial cells, no expression from other cells, correlates with tumour size and increases in tumour progression - increased concentrations: in 84% of MPMs and in less than 2% in other pleural abnormalities (sensitivity 84%, spesificity 99%) - diagnostic use/follow up of treatment?

8 Other clinical diagnostics anemia, trombocytosis, LD",, CRP",, hypersedimentation, elevated transaminases, hypoalbuminemia common findings in advanced stages of MPM Spirometry - the amount of pleural effusion affects, otherwise the change in FVC relates to regression/progression - not used in clinical practice bronchoscopy+bal: no use in diagnostics, sometimes the evaluation of asbestos-exposure

9 TNM staging IMIG (Intl Mesothelioma Interest Group 1994) stage I - IV ~ surgical stage T: involvement of parietal pleural - ( T1a); visceral pleura (T1b-T2), adjacent structures (T3-4) N- ja M- factors as in NSCLC No special use in diagnostics or when evaluating chemotherapy response Important when assessing operability (stages Ia, Ib, II)

10 Prognostic factors male gender, low performance status, advanced stage (Herndon et al. Chest 1998) sarcomatous subtype, leukocytosis, trombocytosis, anemia, high SUVs in FDG-PET (Pass NEJM 2005, O Byrne et al. Lung Cancer 2004) three phase III consecutive trials (Fennell et al. JCO 2005) vinorelbine single (28 pts), vinorelbine - oxaliplatin (70 pts) irinotecan-cisplatin-mitomycin (47 pts) poor prognostic factors were : elevated leukocytes, poor PS, sarcomatous subtype prognostic factors in the treatment (945pts) histology, gender,, smoking, asbestos-exposure, laterality, surgical resection (Flores et al. J Thoracic Oncol 2007)

11 Surgery in MPM surgical procedures alone no survival effect int l consensus: recommended as a part of combination therapy (Waller et al. Lung Cancer 2004) extrapleural pneumonectomy (EPP) in trimodality therapy (183pts) 2 yr survival 38%, 5 yr survival 15% prognostic factors: epithelial, N0 (Sugarbaker et al.j Th Cardiovasc Surg 1999) pleurectomy/decortication good control of pleural effusion, obvious pleural disease removal thoracoscopy with talc pleurodesis fairly good control of pleural effusion long-term tunnelled pleural catheter ( Denver( Denver ) as effective as thoracoscopy with pleurodesis (?)

12 Radiotherapy in MPM has not been shown to alter the survival radiosensitivity of MPM only modest difficult to evaluate; mostly given in treatment combinations profylactic RT prevents tumour seeding along biopsy/chest tube tracts and wounds (Boutin et al. Chest 1995) no survival benefit, not in clinical use Cochrane-review 2006: RT alone vs. chemotherapy/surgery/bsc there are no randomized, validated studies not possible to make conclusions Ung et al. Radiother and Oncol 2006 review - 3 trials, postoperative RT to surgical wounds vs. no RT, no difference in tumour growth - 4 non-randomized trials, hemithx-rt - toxicity" palliative RT to limited fields (less than hemithx) can provide pain relief in 50-70%

13 Chemotherapy in MPM most of the modern chemotherapy agents have been tested mainly small phase II non-randomized trials palliative effect at the most, curative treatment not known cisplatin and antracyclins as single-agents antifolates have shown most effect methotrexate (Solheim Halme et al. 1999), pemetrexed, raltitrexed Solheim et al. 1992, Vogelzang et al. JCO 2003: : phase III randomized trial 448 pts cisplatin 75mg/m!+pemetrexed 500mg/m! vs. cisplatin RRs 41% vs. 17%

14 100 Survival: All Eligible Patients Pemetrexed + Cisplatin (n=226) Cisplatin (n=222) 75 % Alive MST = 9.3 mos HR 0.77 Logrank p-value MST = 12.1 mos Months Method: Kaplan-Meier

15 Patient treated with cisplatin + pemetrexed Baseline Visit 4

16 Chemotherapy in MPM (cont.) phase III; raltitrexed+cis vs. cis 250 pts; RR 24% vs.14%, MS 11.4mo vs. 8.8mo (van Meerbeeck et al. JCO 2005) phase II; carbo+pemetrexed; ; 102 pts, RR 18.6%, SD 47%, MS 12.7mo (Ceresoli et al. JCO 2006) cis+gemcitabine 2 trials; RRs 33% and 48%, alleviation of symptoms, quality of life benefit review 119 trials (8 phase III, 111 phase II, no placebocontr. ) combinations achieve better RRs than single-chemotherapy cisplatin+pemetrexed (or raltitrexed) # recommended for first-line treatment ( Ellis et al. J Thorac Oncol 2006)

17 Chemotherapy in MPM (cont.) Manegold C et al. (IASLC 2007 abstr.) Expanded Access Program (EAP) pemetrexed vs. Cis+pem vs. Carbo+pem PRs: : 10.1% vs. 24.3% vs. 20.7% median time to PD: 6.0mo vs. 7.0mo vs 6.9mo 1year survival: 58.6% vs. 63.1% vs. 64.0% toxicity was feasible in all treatment groups, but in carbo-pem group experienced gr 3-4 toxicity most frequently

18 Chemotherapy in MPM (cont.) Gem+Cis ± bevacizumab in first line treatment Kindler H et al. (ASCO( 2007 abstr.) 53 and 55 patients epithelial subtype: 74% (bevacizumab( bevacizumab-group) vs. 67% median PFS: 6.9mo vs. 6.0mo median survivals: 15.6mo vs. 14.7mo 1y survival: 59% vs. 57% combination of bevacizumab did not give additional effect compared to chemotherapy alone bevacizumab-group if VEGF-level initially low; longer PFS and survival

19 Second-line chemotherapy - no placebo-controlled trials Porta et al. Lung Cancer 2006 Giaccone et al. Eur J Cancer 2002 Fennell et al. Lung Cancer (abstr.) 2003 chemotherapy n RR (%) raltitrexed- oxaliplatin OS (mo) ZD irino-cis-mitomycin cis+pemetrexed EAP-trial (subgroup analysis); ; 153 pts received 2nd or 3rd line treatment; ORR 20%; - cis+pemetrexed (80 pts), OS 7.6 mo (95%CI, mo) or - pemetrexed-single (73pts), OS 4.1 mo (95% CI, 3.2 N/A) (Jänne et al. J Thorac Oncol 2006)

20 Is chemotherapy beneficial in MPM?? no placebo-controlled, randomized trials (1 abstract) natural course of the disease varies (2y-survival! 20% despite treatment?) controlling the pleural effusion already gives marked clinical benefit sarcomatous subtype any benefit?? trial results difficult to evaluate (all subtypes included) MSO1-trial (Muers et. al, ASCO 2007 abstr.) MSO1-trial The role of chemotherapy in MPM BSC vs. BSC+MVP vs. BSC+vinorelbine - no clear evidence that chemotherapy improved survival compared to BSC alone

21 MPM patients in HUCH/ Pulmonary Department evaluation of patients diagnosed new MPM patients male / female: 33 / 6 median age 66yrs (range 51-83yrs) occupational asbestos-exposure 29 (no 5, not known 5) epithelial 27, mixed 3, sarcomatous 5, not defined 4 chemotherapy to 23 patients; (23/39 = 59%) median number of chemotherapy cycles 4 Treatment n cis + pemetrexed 10 carbo + pemetrexed 9 pemetrexed-single 3 carbo + gemcitabine + doxorubicin 1 no chemotherapy 13 did not want chemotherapy 3

22 HUCH Pulmonary Department -clinical experience (cont.) surgical procedures to control the pleural effusion 15/39 patients pleurectomy + decortication 6 indwelled, tunneled pleural catheter 5 talc pleurodesis 2 extrapleural pneumonectomy 2

23 HUCH Pulmonary Department -clinical experience (cont.) responses to chemotherapy (radiological+clinical) PR 5/23 (22%) first line treatment - 3 cis+pem, 1 Cb+pem, 1 pem-single - all were epithelial subtype - survivals : 9mo, 30mo, 34mo, 36mo+,49mo+ SD 10/23 (43%) - 8 epithelial, 1 mixed, 1 sarcomatous - median survival 12mo; 2 still alive > 40mos MPMs diagnosed (all 39pts) - median survival 12 mos (range 2 mos 54mos+) - 2-year survival 26% (10/39)

24 How to proceed in the clinic? adequate verification of mesothelioma (histology, consultation of Inst. Occup. of Health mesothelioma panel if needed) subtype? is there occupational asbestos-exposure (>10 years earlier) statement of the occupational diasese for the insurance company

25 the possibility for radical surgery (EPP) should be evaluated, in combination with chemotherapy ( cis-pem pem?)/rt? good control of pleural effusion for all (decortication /tunnelled pleural catheter)! adequate pain medication chemotherapy when feasible (cis/carbo - pemetrexed x 3-6 or pemetrexed-single) second-line chemotherapy after progression, if PR/SD achieved in first-line (reintroduction of pemetrexed±platinum ±platinum, vinorelbin?, gemcitabine?) targeted therapy (eg. bevacizumab, EGFR-inhibitors etc.) have not yet shown additional benefit

26 Response assessment WHO criteria: feasible in bidimensional measurements modified RECIST-criteria for MPM (Byrne et al. Ann Oncol 2004) - longest unidimensional diameter creates difficulties within curved structures of the thorax ## three axial CT-levels; two thickest tumour lesions are measured (perpendicular to the thoracic wall) sum of these six measurements (PR"30%, PD#20%)

Clinical cases in Malignant Pleural Mesothelioma: Adherence to the ESMO Clinical Practice Guidelines

Clinical cases in Malignant Pleural Mesothelioma: Adherence to the ESMO Clinical Practice Guidelines Clinical cases in Malignant Pleural Mesothelioma: Adherence to the ESMO Clinical Practice Guidelines Wieneke Buikhuisen The Netherlands Cancer Institute Amsterdam The Netherlands Case (1) Male, 56 year

More information

Malignant Mesothelioma State of the Art

Malignant Mesothelioma State of the Art Malignant Mesothelioma State of the Art Paul Baas The Netherlands Cancer Institute August 12, 2011, Carlsbad, CA Summary Diagnosis; epithelial type subdivided Pleiomorphic vs other Staging: IASLC-IMIG

More information

Mesothelioma. Malignant Pleural Mesothelioma

Mesothelioma. Malignant Pleural Mesothelioma Mesothelioma William G. Richards, PhD Brigham and Women s Hospital Malignant Pleural Mesothelioma 2,000-3,000 cases per year (USA) Increasing incidence Asbestos (50-80%, decreasing) 30-40 year latency

More information

بسم هللا الرحمن الرحيم

بسم هللا الرحمن الرحيم بسم هللا الرحمن الرحيم Updates in Mesothelioma By Samieh Amer, MD Professor of Cardiothoracic Surgery Faculty of Medicine, Cairo University History Wagner and his colleagues (1960) 33 cases of mesothelioma

More information

Malignant pleural mesothelioma P/D vs. EPP

Malignant pleural mesothelioma P/D vs. EPP 3 rd International Thoracic Oncology Congress Dresden, September 13 15, 2012 Malignant pleural mesothelioma P/D vs. EPP Walter Weder, MD Professor of Surgery Dokumentenname Datum Seite 1 Extrapleural Pneumonectomy

More information

the standard of care 2009 5/1/2009 Mesothelioma: The standard of care take home messages PILC 2006 Jan.vanmeerbeeck@ugent.be Brussels, March 7, 2009

the standard of care 2009 5/1/2009 Mesothelioma: The standard of care take home messages PILC 2006 Jan.vanmeerbeeck@ugent.be Brussels, March 7, 2009 Mesothelioma: The standard of care Jan.vanmeerbeeck@ugent.be Brussels, March 7, 2009 take home messages PILC 2006 All patients should receive adequate palliation of dyspnea and pain before starting chemotherapy

More information

Management of mesothelioma

Management of mesothelioma Management of mesothelioma Jan.vanmeerbeeck@ugent.be Amsterdam, March 6, 2010 1 management Palliation Symptomatic care Pain Breathlessness Radiotherapy Chemotherapy Surgery Radical (intention to cure)

More information

Malignant Mesothelioma: an Update

Malignant Mesothelioma: an Update Malignant Mesothelioma: an Update Nico van Zandwijk Asbestos Diseases Research Institute Bernie Banton Centre University of Sydney Australia Physicians Week RACP 19-5-2009 Health Risks of Asbestos Fibers

More information

Objectives. Mylene T. Truong, MD. Malignant Pleural Mesothelioma Background

Objectives. Mylene T. Truong, MD. Malignant Pleural Mesothelioma Background Imaging of Pleural Tumors Mylene T. Truong, MD Imaging of Pleural Tumours Mylene T. Truong, M. D. University of Texas M.D. Anderson Cancer Center, Houston, TX Objectives To review tumors involving the

More information

Malignant Mesothelioma Current Approaches to a Difficult Problem. Raja M Flores, MD Thoracic Surgery Memorial Sloan-Kettering Cancer Center

Malignant Mesothelioma Current Approaches to a Difficult Problem. Raja M Flores, MD Thoracic Surgery Memorial Sloan-Kettering Cancer Center Malignant Mesothelioma Current Approaches to a Difficult Problem Raja M Flores, MD Thoracic Surgery Memorial Sloan-Kettering Cancer Center Malignant Pleural Mesothelioma Clinical Presentation Insidious

More information

Extrapleural Pneumonectomy for Malignant Mesothelioma: Pro. Joon H. Lee 9/17/2012

Extrapleural Pneumonectomy for Malignant Mesothelioma: Pro. Joon H. Lee 9/17/2012 Extrapleural Pneumonectomy for Malignant Mesothelioma: Pro Joon H. Lee 9/17/2012 Malignant Pleural Mesothelioma (Epidemiology) Incidence: 7/mil (Japan) to 40/mil (Australia) Attributed secondary to asbestos

More information

Surgical therapy of. who should be operated

Surgical therapy of. who should be operated SAMO Interdisciplinary Workshop on Chest Tumors Lucerne, 13th and 14th January 2012 Surgical therapy of mesothelioma, who should be operated Walter Weder MD Professor of Surgery University Hospital Zurich

More information

Mesothelioma 2014. Paul Baas Department of Thoracic Oncology The Netherlands Cancer Institute Amsterdam

Mesothelioma 2014. Paul Baas Department of Thoracic Oncology The Netherlands Cancer Institute Amsterdam Mesothelioma 2014 Paul Baas Department of Thoracic Oncology The Netherlands Cancer Institute Amsterdam Disclosures Grants from Pfizer and Roche Advisor for MSD and Verastem Once upon a time. http://amlbenzene.net/diseases-asbestos.htm

More information

Pre-workshop exercise

Pre-workshop exercise Setting research priorities for mesothelioma workshop 10 th November 2014 Pre-workshop exercise Your individual ranking of unanswered questions about the diagnosis, treatment and care of mesothelioma Please

More information

Mesothelioma. 1. Introduction. 1.1 General Information and Aetiology

Mesothelioma. 1. Introduction. 1.1 General Information and Aetiology Mesothelioma 1. Introduction 1.1 General Information and Aetiology Mesotheliomas are tumours that arise from the mesothelial cells of the pleura, peritoneum, pericardium or tunica vaginalis [1]. Most are

More information

Malignant Pleural Diseases Advances Clinicians Should Know F Gleeson

Malignant Pleural Diseases Advances Clinicians Should Know F Gleeson Malignant Pleural Diseases Advances Clinicians Should Know F Gleeson The following relevant disclosures, conflicts of interest and/ or financial relationships exist related to this presentation: Consultant

More information

Malignant Mesothelioma

Malignant Mesothelioma Malignant Malignant mesothelioma is a tumour originating from mesothelial cells. 85 95% of mesotheliomas are caused by asbestos exposure. It occurs much more commonly in the chest (malignant pleural mesothelioma)

More information

Malignant Mesothelioma

Malignant Mesothelioma Malignant mesothelioma is a tumour originating from mesothelial cells. 85 95% of mesotheliomas are caused by asbestos exposure. It occurs much more commonly in the chest (malignant pleural mesothelioma)

More information

Screening, early referral and treatment for asbestos related cancer

Screening, early referral and treatment for asbestos related cancer Screening, early referral and treatment for asbestos related cancer Marc de Perrot, MD, MSc, FRCSC Toronto Mesothelioma Research Program University of Toronto Asbestos related diseases Mesothelioma Lung

More information

Maintenance therapy in in Metastatic NSCLC. Dr Amit Joshi Associate Professor Dept. Of Medical Oncology Tata Memorial Centre Mumbai

Maintenance therapy in in Metastatic NSCLC. Dr Amit Joshi Associate Professor Dept. Of Medical Oncology Tata Memorial Centre Mumbai Maintenance therapy in in Metastatic NSCLC Dr Amit Joshi Associate Professor Dept. Of Medical Oncology Tata Memorial Centre Mumbai Definition of Maintenance therapy The U.S. National Cancer Institute s

More information

Research Article Malignant Pleural Mesothelioma Outcomes in the Era of Combined Platinum and Folate Antimetabolite Chemotherapy

Research Article Malignant Pleural Mesothelioma Outcomes in the Era of Combined Platinum and Folate Antimetabolite Chemotherapy Lung Cancer International Volume 2015, Article ID 590148, 7 pages http://dx.doi.org/10.1155/2015/590148 Research Article Malignant Pleural Mesothelioma Outcomes in the Era of Combined Platinum and Folate

More information

NCCN Non-Small Cell Lung Cancer V.1.2011 Update Meeting 07/09/10

NCCN Non-Small Cell Lung Cancer V.1.2011 Update Meeting 07/09/10 Guideline Page and Request NSCL-3 Stage IA, margins positive delete the recommendation for chemoradiation. Stage IB, IIA, margins positive delete the recommendation for chemoradiation + Stage IIA, Stage

More information

Accelerated hemithoracic radiation followed by extrapleural pneumonectomy for malignant pleural mesothelioma

Accelerated hemithoracic radiation followed by extrapleural pneumonectomy for malignant pleural mesothelioma Accelerated hemithoracic radiation followed by extrapleural pneumonectomy for malignant pleural mesothelioma Marc de Perrot, Ronald Feld, Natasha B Leighl, Andrew Hope, Thomas K Waddell, Shaf Keshavjee,

More information

Clinical Indications and Results Following Chest Wall Resection

Clinical Indications and Results Following Chest Wall Resection Clinical Indications and Results Following Chest Wall Resection for Recurrent Malignant Pleural Mesothelioma Ali SO, Burt BM, Groth SS, DaSilva MC, Yeap BY, Richards WG, Baldini EH and Sugarbaker DJ. Division

More information

L Lang-Lazdunski, A Bille, S Marshall, R Lal, D Landau, J Spicer

L Lang-Lazdunski, A Bille, S Marshall, R Lal, D Landau, J Spicer Pleurectomy/decortication, hyperthermic pleural lavage with povidone-iodine and systemic chemotherapy in malignant pleural mesothelioma. A 10-year experience. L Lang-Lazdunski, A Bille, S Marshall, R Lal,

More information

MESOTHELIOMA. Not Just a Late Night Commercial. Graciela Hoal, RN, MSN, ACNP-BC

MESOTHELIOMA. Not Just a Late Night Commercial. Graciela Hoal, RN, MSN, ACNP-BC MESOTHELIOMA Not Just a Late Night Commercial Graciela Hoal, RN, MSN, ACNP-BC Saturday Session Thoracic Surgery Nurse Practitioner Greater Los Angeles Veteran Affairs Objectives Course Objectives: Discuss

More information

Malignant Pleural Mesothelioma in Singapore

Malignant Pleural Mesothelioma in Singapore RESEARCH COMMUNICATION C SP Yip 1, HN Koong 2, CM Loo 3, KW Fong 1* Abstract Aim: To examine the clinical characteristics and outcomes of malignant pleural mesothelioma (MPM) in Singapore. Methods and

More information

ARTICLE IN PRESS. European Journal of Radiology xxx (2009) xxx xxx. Contents lists available at ScienceDirect. European Journal of Radiology

ARTICLE IN PRESS. European Journal of Radiology xxx (2009) xxx xxx. Contents lists available at ScienceDirect. European Journal of Radiology European Journal of Radiology xxx (2009) xxx xxx Contents lists available at ScienceDirect European Journal of Radiology journal homepage: www.elsevier.com/locate/ejrad Three-dimensional evaluation of

More information

Malignant pleural mesothelioma: outcome of limited surgical management

Malignant pleural mesothelioma: outcome of limited surgical management Interactive Cardiovascular and Thoracic Surgery 2 (2003) 30 34 Institutional review Thoracic general Malignant pleural mesothelioma: outcome of limited surgical management Peter G. Phillips a, George Asimakopoulos

More information

Update on Mesothelioma

Update on Mesothelioma November 8, 2012 Update on Mesothelioma Intro incidence and nomenclature Update on Classification Diagnostic specimens Morphologic features Epithelioid Histology Biphasic Histology Immunohistochemical

More information

SAKK Lung Cancer Group. Current activities and future projects

SAKK Lung Cancer Group. Current activities and future projects SAKK Lung Cancer Group Current activities and future projects SAKK Lung Cancer Group Open group of physicians interested in lung cancer Mostly Medical Oncologists, but also Thoracic Surgeons Radiation

More information

Mesothelioma in the UK

Mesothelioma in the UK Mesothelioma in the UK Liz Darlison Mesothelioma UK The National Macmillan Mesothelioma Resource Centre June 2010 Mesothelioma Applied Research Foundation - 2010 www.curemeso.org Contents Size of Mesothelioma

More information

Summary of treatment benefits

Summary of treatment benefits Risk Management Plan PEMETREXED Powder for concentrate for Solution for infusion Pemetrexed is also indicated as monotherapy for the maintenance treatment of locally advanced or metastatic non small cell

More information

Treating Mesothelioma - A Quick Guide

Treating Mesothelioma - A Quick Guide Treating Mesothelioma - A Quick Guide Contents This is a brief summary of the information on Treating mesothelioma from CancerHelp UK. You will find more detailed information on the website. In this information

More information

J Clin Oncol 24:3007-3012. 2006 by American Society of Clinical Oncology INTRODUCTION

J Clin Oncol 24:3007-3012. 2006 by American Society of Clinical Oncology INTRODUCTION VOLUME 24 NUMBER 19 JULY 1 2006 JOURNAL OF CLINICAL ONCOLOGY O R I G I N A L R E P O R T Progression-Free Survival Rate As Primary End Point for Phase II Cancer Clinical Trials: Application to Mesothelioma

More information

Columbia University Mesothelioma Applied Research Foundation - 2009 - www.curemeso.org. Mesothelioma Center www.mesocenter.org

Columbia University Mesothelioma Applied Research Foundation - 2009 - www.curemeso.org. Mesothelioma Center www.mesocenter.org Columbia University Mesothelioma Center www.mesocenter.org Multimodal clinical trials, treatment (surgery, radiation, chemotherapy) Peritoneal mesothelioma program Immunotherapy translational, experimental

More information

Population-based survival for malignant mesothelioma after introduction of novel chemotherapy

Population-based survival for malignant mesothelioma after introduction of novel chemotherapy Eur Respir J 2012; 40: 185 189 DOI: 10.1183/09031936.00153611 CopyrightßERS 2012 Population-based survival for malignant mesothelioma after introduction of novel chemotherapy Ronald A.M. Damhuis*, Caroline

More information

Post-operative intrapleural chemotherapy for mesothelioma

Post-operative intrapleural chemotherapy for mesothelioma Post-operative intrapleural chemotherapy for mesothelioma Robert Kratzke, MD John Skoglund Chair for Lung Cancer Research Section of Heme-Onc-Transplant University of Minnesota Medical School Efficacy

More information

Malignant Pleural Mesothelioma

Malignant Pleural Mesothelioma Malignant Pleural Mesothelioma Joseph Friedberg, MD Hedy Lee Kindler, MD Lee Krug, MD Kenneth Rosenzweig, MD Epidemiology of Mesothelioma Incidence: 2,500 3,000 cases year in the US 5,000 cases per year

More information

Chemotherapy in Ovarian Cancer. Dr R Jones Consultant Medical Oncologist South Wales Gynaecological Oncology Group

Chemotherapy in Ovarian Cancer. Dr R Jones Consultant Medical Oncologist South Wales Gynaecological Oncology Group Chemotherapy in Ovarian Cancer Dr R Jones Consultant Medical Oncologist South Wales Gynaecological Oncology Group Adjuvant chemotherapy for early stage EOC Fewer than 30% women present with FIGO stage

More information

Multidisciplinary discussion of: Early staged NSCLC

Multidisciplinary discussion of: Early staged NSCLC Multidisciplinary discussion of: Early staged NSCLC 2 different classes of patients Stage IIIA pt2pn2 Stage IIB pt3pn0 2 different classes of patients 50% 40% 30% 20% 10% 3y survival 50% 40% 30% 20% 10%

More information

Avastin: Glossary of key terms

Avastin: Glossary of key terms Avastin: Glossary of key terms Adenocarcinoma Adenoma Adjuvant therapy Angiogenesis Anti-angiogenics Antibody Antigen Avastin (bevacizumab) Benign A form of carcinoma that originates in glandular tissue.

More information

Mesothelioma: Questions and Answers

Mesothelioma: Questions and Answers CANCER FACTS N a t i o n a l C a n c e r I n s t i t u t e N a t i o n a l I n s t i t u t e s o f H e a l t h D e p a r t m e n t o f H e a l t h a n d H u m a n S e r v i c e s Mesothelioma: Questions

More information

Advances in Treatment of Malignant Pleural Mesothelioma: A Reason for Hope

Advances in Treatment of Malignant Pleural Mesothelioma: A Reason for Hope Advances in Treatment of Malignant Pleural Mesothelioma: A Reason for Hope Daniel H. Sterman, M.D. Associate Professor of Medicine and Surgery Co-Director, PENN Mesothelioma and Pleural Program University

More information

Clinical characteristics, treatment and survival outcomes in malignant pleural mesothelioma: An institutional experience in Turkey

Clinical characteristics, treatment and survival outcomes in malignant pleural mesothelioma: An institutional experience in Turkey JBUON 2014; 19(1): 164-170 ISSN: 1107-0625, online ISSN: 2241-6293 www.jbuon.com E-mail: editorial_office@jbuon.com ORIGINAL ARTICLE Clinical characteristics, treatment and survival outcomes in malignant

More information

Survey of Mesothelioma Associated with Asbestos Exposure in Japan

Survey of Mesothelioma Associated with Asbestos Exposure in Japan The research and development and the dissemination projects related to the 13 fields of occupational injuries and illnesses Survey of Mesothelioma Associated with Asbestos Exposure in Japan Clinical characteristics

More information

Round Table with Drs. Anne Tsao and Alex Farivar, Case 2: Mesothelioma

Round Table with Drs. Anne Tsao and Alex Farivar, Case 2: Mesothelioma Round Table with Drs. Anne Tsao and Alex Farivar, Case 2: Mesothelioma I d like to welcome everyone, thanks for coming out to our lunch with experts. The faculty today are great people in the thoracic

More information

SMALL CELL LUNG CANCER

SMALL CELL LUNG CANCER Protocol for Planning and Treatment The process to be followed in the management of: SMALL CELL LUNG CANCER Patient information given at each stage following agreed information pathway 1. DIAGNOSIS New

More information

Is the third-line chemotherapy feasible for non-small cell lung cancer? A retrospective study

Is the third-line chemotherapy feasible for non-small cell lung cancer? A retrospective study Turkish Journal of Cancer Volume 34, No.1, 2004 19 Is the third-line chemotherapy feasible for non-small cell lung cancer? A retrospective study MUSTAFA ÖZDO AN, MUSTAFA SAMUR, HAKAN BOZCUK, ERKAN ÇOBAN,

More information

GUIDELINES FOR THE MANAGEMENT OF LUNG CANCER

GUIDELINES FOR THE MANAGEMENT OF LUNG CANCER GUIDELINES FOR THE MANAGEMENT OF LUNG CANCER BY Ali Shamseddine, MD (Coordinator); as04@aub.edu.lb Fady Geara, MD Bassem Shabb, MD Ghassan Jamaleddine, MD CLINICAL PRACTICE GUIDELINES FOR THE TREATMENT

More information

Principal Investigator: Valerie W. Rusch, MD, FACS, Chief, Thoracic Surgery Memorial Sloan-Kettering Cancer Center

Principal Investigator: Valerie W. Rusch, MD, FACS, Chief, Thoracic Surgery Memorial Sloan-Kettering Cancer Center Protocol 1101-1088 Phase I study of intra-pleural administration of GL-ONC1 in patients with malignant pleural effusion: primary, metastases and mesothelioma Principal Investigator: Valerie W. Rusch, MD,

More information

INTERNATIONAL ASSOCIATION FOR THE STUDY OF LUNG CANCER Prospective Mesothelioma Staging Project

INTERNATIONAL ASSOCIATION FOR THE STUDY OF LUNG CANCER Prospective Mesothelioma Staging Project INTERNATIONAL ASSOCIATION FOR THE STUDY OF LUNG CANCER Prospective Mesothelioma Staging Project Data Forms and Fields in CRAB Electronic Data Capture System - Reduced Set - Pivotal data elements for developing

More information

Understanding Pleural Mesothelioma

Understanding Pleural Mesothelioma Understanding Pleural Mesothelioma UHN Information for patients and families Read this booklet to learn about: What is pleural mesothelioma? What causes it? What are the symptoms? What tests are done to

More information

MesoPDT. Photodynamic Therapy for malignant pleural mesothelioma ONCO-THAI. Image Assisted Laser Therapy for Oncology

MesoPDT. Photodynamic Therapy for malignant pleural mesothelioma ONCO-THAI. Image Assisted Laser Therapy for Oncology MesoPDT Photodynamic Therapy for malignant pleural mesothelioma ONCO-THAI Image Assisted Laser Therapy for Oncology Unité Inserm ONCO-THAI «Image Assisted Laser Therapy for Oncology» Inserm ONCO-THAI "Image

More information

REPORT PERSPECTIVES IN LUNG CANCER 2010 AMSTERDAM

REPORT PERSPECTIVES IN LUNG CANCER 2010 AMSTERDAM REPORT PERSPECTIVES IN LUNG CANCER 2010 AMSTERDAM Valerie Van Damme, Isabelle Wauters, Johan Vansteenkiste Univ. Hospital Leuven and Leuven Lung Cancer Group Introduction Perspectives in Lung Cancer (PILC)

More information

Activity of pemetrexed in thoracic malignancies

Activity of pemetrexed in thoracic malignancies Activity of pemetrexed in thoracic malignancies Results of phase III clinical studies of pemetrexed in malignant pleural mesothelioma and non-small cell lung cancer show benefit P emetrexed (Alimta) is

More information

B10/S/a Cancer: Malignant Mesothelioma (Adult)

B10/S/a Cancer: Malignant Mesothelioma (Adult) B10/S/a 2013/14 NHS STANDARD CONTRACT FOR CANCER: MALIGNANT MESOTHELIOMA (ADULT) SECTION B PART 1 - SERVICE SPECIFICATIONS Service Specification No. Service Commissioner Lead Provider Lead Period Date

More information

Come è cambiata la storia naturale della malattia

Come è cambiata la storia naturale della malattia Malattia Metastatica del Carcinoma del Grosso Intestino Tecniche e terapie Innovative Come è cambiata la storia naturale della malattia Antonio Frassoldati Oncologia Clinica - Ferrara 29 ottobre 2011 Colorectal

More information

ASBESTOS EXPOSURE AND SARCOMATOID MALIGNANT PLEURAL MESOTHELIOMA Gorantla Sambasivarao 1, Namballa Usharani 2, Tupakula Suresh Babu 3

ASBESTOS EXPOSURE AND SARCOMATOID MALIGNANT PLEURAL MESOTHELIOMA Gorantla Sambasivarao 1, Namballa Usharani 2, Tupakula Suresh Babu 3 ASBESTOS EXPOSURE AND SARCOMATOID MALIGNANT PLEURAL MESOTHELIOMA Gorantla Sambasivarao 1, Namballa Usharani 2, Tupakula Suresh Babu 3 HOW TO CITE THIS ARTICLE: Gorantla Sambasivarao, Namballa Usharani,

More information

Sternotomy and removal of the tumor

Sternotomy and removal of the tumor Sternotomy and removal of the tumor All thymomas originate from epithelial thymic cells 4% of them consist of a pure population of epithelial cells Most have mixed populations of lymphoid cells to a

More information

Is pleurectomy and decortication superior to palliative care in the treatment of malignant pleural mesothelioma?

Is pleurectomy and decortication superior to palliative care in the treatment of malignant pleural mesothelioma? doi:10.1510/icvts.2010.256271 Interactive CardioVascular and Thoracic Surgery 12 (2011) 812 817 www.icvts.org Best evidence topic - Thoracic oncologic Is pleurectomy and decortication superior to palliative

More information

Malignant Pleural Mesothelioma. Rolf Stahel, MD University Hospital Zurich, Switzerland

Malignant Pleural Mesothelioma. Rolf Stahel, MD University Hospital Zurich, Switzerland Malignant Pleural Mesothelioma Rolf Stahel, MD University Hospital Zurich, Switzerland Luzerne, 14.1.2012 Mesothelioma Questions 1 The following statement about pleural mesothelioma is correct 1) Dyspnoe

More information

Adjuvant Therapy Non Small Cell Lung Cancer. Sunil Nagpal MD Director, Thoracic Oncology Jan 30, 2015

Adjuvant Therapy Non Small Cell Lung Cancer. Sunil Nagpal MD Director, Thoracic Oncology Jan 30, 2015 Adjuvant Therapy Non Small Cell Lung Cancer Sunil Nagpal MD Director, Thoracic Oncology Jan 30, 2015 No Disclosures Number of studies Studies Per Month 12 10 8 6 4 2 0 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3

More information

COMMISSIONING. for ULTRA-RADICAL SURGERY ADVANCED OVARIAN CANCER

COMMISSIONING. for ULTRA-RADICAL SURGERY ADVANCED OVARIAN CANCER COMMISSIONING for ULTRA-RADICAL SURGERY in ADVANCED OVARIAN CANCER WHY THIS MUST HAPPEN PERSPECTIVE COMMISSIONING FOR WHO, FOR WHAT? Biological Basis Surgical Basis International and national standards

More information

Asbestos and your lungs

Asbestos and your lungs This information describes what asbestos is and the lung conditions that are caused by exposure to it. It also includes information about what to do if you have been exposed to asbestos, and the benefits

More information

HEALTH CARE FOR EXPOSURE TO ASBESTOS. 2010 The SafetyNet Centre for Occupational Health and Safety Research Memorial University www.safetynet.mun.

HEALTH CARE FOR EXPOSURE TO ASBESTOS. 2010 The SafetyNet Centre for Occupational Health and Safety Research Memorial University www.safetynet.mun. HEALTH CARE FOR PATIENTS WITH EXPOSURE TO ASBESTOS 2010 The SafetyNet Centre for Occupational Health and Safety Research Memorial University www.safetynet.mun.ca HEALTH CARE FOR PATIENTS WITH EXPOSURE

More information

Lung Cancer and Mesothelioma

Lung Cancer and Mesothelioma Lung Cancer and Mesothelioma Robert Kratzke, M.D. John C. Skoglund Professor of Lung Cancer Research Section of Heme/Onc/Transplant Department of Medicine University of Minnesota Medical School Malignant

More information

Malignant Mesothelioma Recent Advances

Malignant Mesothelioma Recent Advances Malignant Mesothelioma Recent Advances Dr AS Paul 04 Aug 06 DM Seminar Malignant mesothelioma A tumour of serosal surfaces Pleura, peritoneum Increasing incidence worldwide Association with asbestos exposure

More information

Therapy of pleural effusions Modern techniques

Therapy of pleural effusions Modern techniques Therapy of pleural effusions Modern techniques Dr. Melanie Toffel Sugery of the chest Pleural effusion Ethiology In the normal pleural space there is a steady state in which there is a roughly equal rate

More information

U.S. Food and Drug Administration

U.S. Food and Drug Administration U.S. Food and Drug Administration Notice: Archived Document The content in this document is provided on the FDA s website for reference purposes only. It was current when produced, but is no longer maintained

More information

Management of stage III A-B of NSCLC. Hamed ALHusaini Medical Oncologist

Management of stage III A-B of NSCLC. Hamed ALHusaini Medical Oncologist Management of stage III A-B of NSCLC Hamed ALHusaini Medical Oncologist Global incidence, CA cancer J Clin 2011;61:69-90 Stage III NSCLC Includes heterogeneous group of patients with differences in the

More information

Dr Peter Briggs Medical Oncologist. Lung Cancer & Mesothelioma: is it worth treating?

Dr Peter Briggs Medical Oncologist. Lung Cancer & Mesothelioma: is it worth treating? Dr Peter Briggs Medical Oncologist Lung Cancer & Mesothelioma: is it worth treating? GOALS OF CANCER THERAPY CURE Good chance Medium chance Low chance PALLIATION Life prolonging Symptomatic improvement

More information

Prior Authorization Guideline

Prior Authorization Guideline Prior Authorization Guideline Guideline: PS Inj - Alimta Therapeutic Class: Antineoplastic Agents Therapeutic Sub-Class: Antifolates Client: PS Inj Approval Date: 8/2/2004 Revision Date: 12/5/2006 I. BENEFIT

More information

Characteristics of Malignant Pleural Mesothelioma in Women

Characteristics of Malignant Pleural Mesothelioma in Women Characteristics of Malignant Pleural Mesothelioma in Women Andrea S. Wolf, MD, MPH, William G. Richards, PhD, Tamara R. Tilleman, MD, PhD, Lucian Chirieac, MD, Shelley Hurwitz, PhD, Raphael Bueno, MD,

More information

P L E U R A L M E S O T H E L I O M A

P L E U R A L M E S O T H E L I O M A For media outside the US, UK and Canada only P L E U R A L M E S O T H E L I O M A 1. Overview 2. What is pleural mesothelioma? 3. How common is pleural mesothelioma? 4. What are the risk factors for pleural

More information

Treatment of mesothelioma in Bloemfontein, South Africa

Treatment of mesothelioma in Bloemfontein, South Africa European Journal of Cardio-thoracic Surgery 24 (2003) 434 440 www.elsevier.com/locate/ejcts Treatment of mesothelioma in Bloemfontein, South Africa W.J. de Vries*, M.A. Long Cardiothoracic Department,

More information

New Trends & Current Research in the Treatment of Lung Cancer, Pt. II

New Trends & Current Research in the Treatment of Lung Cancer, Pt. II New Trends & Current esearch in the Treatment of Lung Cancer, Pt. II Howard (Jack) West, MD President & CEO, GACE Medical Director, Thoracic Oncology Program Swedish Cancer Institute Seattle, WA Cancer

More information

Harmesh Naik, MD. Hope Cancer Clinic HOW DO I MANAGE STAGE 4 NSCLC IN 2012: STATE OF THE ART

Harmesh Naik, MD. Hope Cancer Clinic HOW DO I MANAGE STAGE 4 NSCLC IN 2012: STATE OF THE ART Harmesh Naik, MD. Hope Cancer Clinic HOW DO I MANAGE STAGE 4 NSCLC IN 2012: STATE OF THE ART Goals Discuss treatment options for stage 4 lung cancer: New and old Discuss new developments in personalized

More information

Overview of Mesothelioma. Raffit Hassan, M.D.

Overview of Mesothelioma. Raffit Hassan, M.D. Overview of Mesothelioma Raffit Hassan, M.D. Mesothelioma Is an aggressive tumor that arises from the serosal surfaces of body cavities In 1960, Wagner reported increased incidence of mesothelioma in asbestos

More information

ASBESTOS MANAGEMENT REVIEW A CRITICAL REVIEW OF MEDICAL MANAGEMENT IN MALIGNANT PLEURAL MESOTHELIOMA - AUSTRALIA, 2011

ASBESTOS MANAGEMENT REVIEW A CRITICAL REVIEW OF MEDICAL MANAGEMENT IN MALIGNANT PLEURAL MESOTHELIOMA - AUSTRALIA, 2011 ASBESTOS MANAGEMENT REVIEW A CRITICAL REVIEW OF MEDICAL MANAGEMENT IN MALIGNANT PLEURAL MESOTHELIOMA - AUSTRALIA, 2011 Dr Malcolm Feigen Senior Radiation Oncologist Radiation Oncology Centre Austin Health

More information

Kasr El-Aini Center of Clinical Oncology, Faculty of medicine, 2 Chest Department, Faculty of medicine, Cairo University, egypt

Kasr El-Aini Center of Clinical Oncology, Faculty of medicine, 2 Chest Department, Faculty of medicine, Cairo University, egypt Kasr El-aini J. Clin. Oncol. nucl. med. vol., no. 3-4, Jul.-oct. 006:4-47 NEMROCK Original Article Phase II Trial of Cisplatin and Vinorelbine as First-line Therapy in Malignant Pleural Mesothelioma Salah

More information

PRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES

PRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES PRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES LUNG SITE MESOTHELIOMA Lung Site Group Mesothelioma Date Guideline Created: April 2013 Authors: Dr. Meredith Giuliani, Dr. Andrea Bezjak 1.

More information

Scottish Medicines Consortium

Scottish Medicines Consortium Scottish Medicines Consortium pemetrexed 500mg infusion (Alimta ) No. (192/05) Eli Lilly 8 July 2005 The Scottish Medicines Consortium has completed its assessment of the above product and advises NHS

More information

Choosing a Clinical Trial for Advanced Mesothelioma

Choosing a Clinical Trial for Advanced Mesothelioma Choosing a Clinical Trial for Advanced Mesothelioma RN Taub (Onc) J Chabot (Surg) A Borczuk (Path) J Sonnet (Surg) M Kluger (Surg) R Fawwaz (Nuc. Med) E Hare (Onc) Columbia University Mesothelioma Center

More information

Ahmed Farouk Abd El-Hafez, MD

Ahmed Farouk Abd El-Hafez, MD Presented By Ahmed Farouk Abd El-Hafez, MD Lecturer of Cardiothoracic Surgery Assiut University Asbestos exposure : amphibole fibers especially crocidolite asbestos Nonasbestos Causes : Silicate fibers

More information

Targeting Specific Cell Signaling Pathways for the Treatment of Malignant Peritoneal Mesothelioma

Targeting Specific Cell Signaling Pathways for the Treatment of Malignant Peritoneal Mesothelioma The Use of Kinase Inhibitors: Translational Lab Results Targeting Specific Cell Signaling Pathways for the Treatment of Malignant Peritoneal Mesothelioma Sheelu Varghese, Ph.D. H. Richard Alexander, M.D.

More information

London Cancer. Mesothelioma Lung Protocols

London Cancer. Mesothelioma Lung Protocols London Cancer Mesothelioma Lung Protocols Version 0.9 Contents 1. Staging... 3 2. Mesothelioma Summary of Chemotherapy Protocols... 4 3. Mesothelioma Chemotherapy Protocols... 7 3.1. Pemetrexed (Alimta

More information

Multimodal management of malignant pleural mesothelioma: where are we today?

Multimodal management of malignant pleural mesothelioma: where are we today? SERIES THORACIC ONCOLOGY Multimodal management of malignant pleural mesothelioma: where are we today? Paul E. Van Schil 1, Isabelle Opitz 2, Walter Weder 2, Christophe De Laet 1, Andreas Domen 1, Patrick

More information

Controversies in Management of. Inoperable NSCLC. Inoperable NSCLC. Introduction:

Controversies in Management of. Inoperable NSCLC. Inoperable NSCLC. Introduction: Inoperable NSCLC Controversies in Management of Inoperable NSCLC Introduction: It is difficult to overemphasize the magnitude of lung cancer as Public Health Problem in our society. - In US, Lung cancer

More information

The activity of raltitrexed (Tomudex 1 ) in malignant pleural mesothelioma: an EORTC phase II study (08992)

The activity of raltitrexed (Tomudex 1 ) in malignant pleural mesothelioma: an EORTC phase II study (08992) European Journal of Cancer 39(2003) 353 357 www.ejconline.com The activity of raltitrexed (Tomudex 1 ) in malignant pleural mesothelioma: an EORTC phase II study (08992) P. Baas a, *, A. Ardizzoni b, F.

More information

Malignant Pleural Mesothelioma. NCCN Guidelines for Patients

Malignant Pleural Mesothelioma. NCCN Guidelines for Patients Malignant Pleural Mesothelioma NCCN Guidelines for Patients Presented with support from the national law firm of Baron & Budd Also available at NCCN.com About this booklet Its purpose Learning that you

More information

Small cell Lung cancer New Chemotherapy options. Nicolas Mach, MD,PD

Small cell Lung cancer New Chemotherapy options. Nicolas Mach, MD,PD Small cell Lung cancer New Chemotherapy options Nicolas Mach, MD,PD > 40 negative Phase III trials List of unsucessful drugs Pemetrexed, imatinib, bevacizumab, bcl-2 antagonist, ASCT, CASE PRESENTATION

More information

Do we need a revised staging system for malignant pleural mesothelioma? Analysis of the IASLC database

Do we need a revised staging system for malignant pleural mesothelioma? Analysis of the IASLC database Featured Article Do we need a revised staging system for malignant pleural mesothelioma? Analysis of the IASLC database Valerie W. Rusch 1, Dorothy Giroux 2 1 Memorial Sloan-Kettering Cancer Center, New

More information

Trials in Elderly Melanoma Patients (with a focus on immunotherapy)

Trials in Elderly Melanoma Patients (with a focus on immunotherapy) Trials in Elderly Melanoma Patients (with a focus on immunotherapy) Where we were Immunotherapy Trials: past and present Relevance for real world practice Where we are SIOG October 2012 James Larkin FRCP

More information

Exploring the Role of Vitamins in Achieving a Healthy Heart

Exploring the Role of Vitamins in Achieving a Healthy Heart Exploring the Role of Vitamins in Achieving a Healthy Heart There are many avenues you can take to keep your heart healthy. The first step you should take is to have a medical professional evaluate the

More information

Lung Cancer: Practical Application of Imaging In Determining Resectability. Jeremy J. Erasmus, M. D.

Lung Cancer: Practical Application of Imaging In Determining Resectability. Jeremy J. Erasmus, M. D. Lung Cancer: Practical Application of Imaging In Determining Resectability Jeremy J. Erasmus, M. D. 62 year old man with a superior sulcus tumor. Which of the following precludes surgical resection in

More information

BACKGROUND. Pemetrexed-cisplatin chemotherapy is the standard of care in the

BACKGROUND. Pemetrexed-cisplatin chemotherapy is the standard of care in the 1555 Gemcitabine and Vinorelbine in Pemetrexed-Pretreated Patients With Malignant Pleural Mesothelioma Paolo A. Zucali, MD 1 Giovanni L. Ceresoli, MD 1 Isabella Garassino, MD 1 Fabio De Vincenzo, MD 1

More information

Treatment Paradigm in NSCLC Treatment

Treatment Paradigm in NSCLC Treatment Treatment Paradigm in NSCLC Treatment Era of Targeted Therapy Aumkhae Sookprasert, MD Medicine Department, KKU Which factors taken to be account in NSCLC treatment? 1. Staging 2. ECOG performance status

More information

Good symptom relief with palliative MVP (mitomycin-c, vinblastine and cisplatin) chemotherapy in malignant mesothelioma

Good symptom relief with palliative MVP (mitomycin-c, vinblastine and cisplatin) chemotherapy in malignant mesothelioma Annals of Oncology 9: 9-7, 998. 998 Khmer Academic Publishers. Printed in the Netherlands Original article Good symptom relief with palliative MVP (mitomycin-c, vinblastine and cisplatin) chemotherapy

More information

Lung Cancer: More than meets the eye

Lung Cancer: More than meets the eye Lung Cancer Education Program November 23, 2013 Lung Cancer: More than meets the eye Shantanu Banerji MD, FRCPC Presenter Disclosure Faculty: Shantanu Banerji Relationships with commercial interests: Grants/Research

More information