Post-operative intrapleural chemotherapy for mesothelioma

Size: px
Start display at page:

Download "Post-operative intrapleural chemotherapy for mesothelioma"

Transcription

1 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

2 Efficacy of Mesothelioma Treatment Single modal therapy Minimal improvement in survival Trimodal therapy Mean survival, 19 months Sugarbaker et al. J Thorac Cardiovasc Surg (1):

3 Limitation of Trimodal Therapy High local recurrence rates 35% ipsilateral hemithorax 67% of all recurrences Baldini et al. Ann Thorac Surg (2): Need treatment with better local tumor control

4 Hyperthermic Intracavitary Chemotherapy: The Solution? Treatment of peritoneal carcinomatosis Improved survival Improved quality of life Sebbag et al. Br J Surg. Nov 2000;87(11): Stamm & Bigler. Gynaecologia. 1968;165(2): Park et al. Ann Surg Oncol. Sep 1999;6(6): Pestieau et al. Eur J Surg Oncol. Nov 2000;26(7): Jaaback & Johnson. Cochrane Database Syst Rev. 2006(1):CD Knutsen et al. J Gastrointest Surg. Jul-Aug 2006;10(7): Sugarbaker. Lancet Oncol. Jan 2006;7(1):69-76.

5 Benefits of Hyperthermic Intracavitary Chemotherapy Benefit of intracavitary chemotherapy Directly deliver drug to cancer cells Maximizes efficacy Limits systemic toxicities Benefits of hyperthermia Direct cytotoxic effect on cells Synergistic with chemotherapy

6 Intrathoracic Chemotherapy for Mesothelioma Feasible Adequate cytoreduction is essential Rusch et al. J Clin Oncol (6): Lee et al. J Surg Oncol (4): Colleoni et al. Tumori (1): Ratto et al. J Thorac Cardiovasc Surg (4): Yellin et al. Cancer (8): van Ruth et al. Ann Surg Oncol (2): Richards et al. J Clin Oncol (10):

7 Survival estimates for (A) enrolled patients and (B through E) patients undergoing pleurectomy/decortication and intraoperative intracavitary hyperthermic cisplatin therapy Richards, W. G. et al. J Clin Oncol; 24: Copyright American Society of Clinical Oncology

8 Recurrence interval in resected patients Richards, W. G. et al. J Clin Oncol; 24: Richards, W. G. et al. J Clin Oncol; 24: Copyright American Society of Clinical Oncology

9 Most Effective Drug for Intrathoracic Administration? Response rates to systemic chemotherapy for MPM 10-20% with most regimens Samson et al. J Clin Oncol (1): Ardizzoni et al. Cancer (12): van Meerbeeck et al. J Clin Oncol (28): % with pemetrexed/cisplatin in patients with unresectable disease Vogelzang et al J Clin Oncol (14):

10 Properties of Pemetrexed That Make It Ideal Highly soluble Short half-life Stable at hyperthermic temperatures for long periods of time

11 Pharmacokinetics of Pemetrexed Animal studies suggest potential benefit Intracavity:plasma AUC Intracavity administration: 40.8 Systemic administration: Pestieau et al. Eur J Surg Oncol (7): Reasons to characterize pharmacokinetics of intrathoracic administration AUC is directly related to toxicity Optimize efficacy

12 Treatment Timeline Cytoreductive operation concurrent with hyperthermic intracavitary chemotherapy added morbidity vs. delayed treatment Knutsen et al. J Gastrointest Surg (7): VATS infusion of hyperthermic chemotherapy is safe Shigemura et al. Ann Thorac Surg (3):

13 Hypothesis Safe method Can administer higher levels of pemetrexed vs. systemic therapy TS synthase gene expression in MPM is associated with response to pemetrexed

14 Phase I Study Using Video- Assisted Thoracoscopic Surgery to Infuse Hyperthermic Pemetrexed as Part of a Multimodal Approach to the Treatment of Malignant Pleural Mesotheliomas

15 Specific Aims Specific Aim #1: Determine the MTD Specific Aim #2: Elucidate the pharmocokinetics, pharmacodynamics, and pharmacogenetics Specific Aim #3: Quantitate TS expression in MPM removed during EPP

16 Registration/Radiographic Staging/Assessment of Physiologic Fitness Resectable Days B12 & Folate 7 Days Mediastinoscopy -LN Talc Pleurodesis EPP +LN Unresectable Disease Off Study Treatment VATS INFUSION HYPERTHERMIC PEMETREXED 42 C for 90 min Dose Escalation Schedule Cohort A 300 mg/m2 Cohort B 400 mg/m2 Cohort C 500 mg/m2 Cohort D 600 mg/m2 Systemic Chemotherapy (cisplatin/pemetrexed) & XRT

17 Anticipated Side Effects Constitutional: Fatigue, fever, shivers Respiratory: Dyspnea, pharyngitis. Cardiovascular: Thrombosis/embolism. Gastrointestinal: Loss of appetite, nausea/vomiting, diarrhea, stomatitis Renal: Creatinine elevation. Renal failure. Hematologic: Cytopenia Dermatologic: Rash/desquamation Musculoskeletal: Chest pain Infectious Disease: Infection Immune: Allergic reaction Neurologic: Sensory changes, mood alterations HITC: Arrhythmias, anastomotic leak

18 Quantitation of Thymidylate Synthase (TS) Expression MPM stored fresh -80 ºC Total RNA isolated using Trizol method cdna reverse transcribed TS expression quantified using PCR

19 Where do we go from here? Intrathoracic chemotherapy after surgery with pemetrexed may reduce MPM recurrence rates Phase I study is active at Minnesota Need to study pharmacology TS gene expression may be important in order to tailor treatment

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

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

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

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

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

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

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

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

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

Hyperthermic Intraperitoneal Chemotherapy (HIPEC) as Part of an Integrative Treatment Plan for Colorectal Peritoneal Carcinomatosis

Hyperthermic Intraperitoneal Chemotherapy (HIPEC) as Part of an Integrative Treatment Plan for Colorectal Peritoneal Carcinomatosis Hyperthermic Intraperitoneal Chemotherapy (HIPEC) as Part of an Integrative Treatment Plan for Colorectal Peritoneal Carcinomatosis T. Christopher Windham, M.D., F.A.C.S. Medical Director, Florida Hospital

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

Peritoneal Carcinomatosis: Pathophysiology, Prevention, and Treatment

Peritoneal Carcinomatosis: Pathophysiology, Prevention, and Treatment Peritoneal Carcinomatosis: Pathophysiology, Prevention, and Treatment Wim Ceelen, MD, PhD, FACS GI Surgery, UZ Gent KAGB 27/4/2013 Overview What is peritoneal carcinomatosis? Rationale for IP drug delivery

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

A Case of Advanced Malignant Pleural Mesothelioma Treatment with Chemotherapy and Photodynamic Therapy

A Case of Advanced Malignant Pleural Mesothelioma Treatment with Chemotherapy and Photodynamic Therapy CASE REPORT http://dx.doi.org/10.4046/trd.2015.78.1.36 ISSN: 1738-3536(Print)/2005-6184(Online) Tuberc Respir Dis 2015;78:36-40 A Case of Advanced Malignant Pleural Mesothelioma Treatment with Chemotherapy

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

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

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

Intraoperative Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Volodymyr Labinskyy MD

Intraoperative Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Volodymyr Labinskyy MD Intraoperative Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Volodymyr Labinskyy MD KCHC 8/29/13 52 y.o. F presented with severe pain in the right back and right flank, sharp, 8 out of 10, for 7 days.

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

Brigham and Women s Hospital, Boston, MA, USA; 2 Verastem, Inc., Boston, MA, USA

Brigham and Women s Hospital, Boston, MA, USA; 2 Verastem, Inc., Boston, MA, USA Determination of Biomarker Response in a Phase II Window of Opportunity Study of Defactinib (VS 6063), a Focal Adhesion Kinase (FAK) Inhibitor, in Patients with Resectable Malignant Pleural Mesothelioma

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

H. Richard Alexander, Jr., M.D. Department of Surgery and The Greenebaum Cancer Center University of Maryland School of Medicine Baltimore, Md

H. Richard Alexander, Jr., M.D. Department of Surgery and The Greenebaum Cancer Center University of Maryland School of Medicine Baltimore, Md Major Advances in Cancer Prevention, Diagnosis and Treatment~ Why Mesothelioma Leads the Way H. Richard Alexander, Jr., M.D. Department of Surgery and The Greenebaum Cancer Center University of Maryland

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

Cytoreduction and hyperthermic intraperitoneal chemotherapy for the treatment of pseudomyxoma

Cytoreduction and hyperthermic intraperitoneal chemotherapy for the treatment of pseudomyxoma Medical Policy Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy for the Treatment of Pseudomyxoma Peritonei and Peritoneal Carcinomatosis of Gastrointestinal Origin, and Peritoneal Mesothelioma

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

Peritoneal Surface Malignancies. Ira Allen Jacobs, MD, FACS Surgical Oncology San Diego, CA

Peritoneal Surface Malignancies. Ira Allen Jacobs, MD, FACS Surgical Oncology San Diego, CA Peritoneal Surface Malignancies Ira Allen Jacobs, MD, FACS Surgical Oncology San Diego, CA Cancer dissemination routes Hematogenous metastases Lymphatic metastases Implants on peritoneal surfaces Surgically

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

FATAL PNEUMONITIS ASSOCIATED WITH INTENSITY-MODULATED RADIATION THERAPY FOR MESOTHELIOMA

FATAL PNEUMONITIS ASSOCIATED WITH INTENSITY-MODULATED RADIATION THERAPY FOR MESOTHELIOMA RAPID COMMUNICATION FATAL PNEUMONITIS ASSOCIATED WITH INTENSITY-MODULATED RADIATION THERAPY FOR MESOTHELIOMA AARON M. ALLEN, M.D.,* MARIA CZERMINSKA, M.S.,* PASI A. JÄNNE, M.D., PH.D., DAVID J. SUGARBAKER,

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

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

Report on New Patented Drugs - Alimta

Report on New Patented Drugs - Alimta Report on New Patented Drugs - Alimta Under its transparency initiative, the PMPRB publishes the results of the reviews of new patented drugs by Board Staff, for purposes of applying the PMPRB s Excessive

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

A succesfull case of HIPEC in a peritoneal mesothelioma patient

A succesfull case of HIPEC in a peritoneal mesothelioma patient A succesfull case of HIPEC in a peritoneal mesothelioma patient Firmino, NLJ¹²; Miranda, E¹³; Oliveira, DA ²; Lima, MBA ¹²; Diniz, AF ¹²; Gomes, GES ¹²; Azevedo, LW ¹²; Soares,MC¹²; Gomes, ASA³. ¹Pernambuco

More information

West of Scotland Cancer Network Chemotherapy Protocol. Cisplatin and Pemetrexed for Malignant Mesothelioma (LUWOS 0021)

West of Scotland Cancer Network Chemotherapy Protocol. Cisplatin and Pemetrexed for Malignant Mesothelioma (LUWOS 0021) West of Scotland Cancer Network Chemotherapy Protocol Cisplatin and Pemetrexed for Malignant Mesothelioma (LUWOS 0021) Indication Palliative chemotherapy for malignant mesothelioma of the pleura Eligibility

More information

Chapter 7: Lung Cancer

Chapter 7: Lung Cancer Chapter 7: Lung Cancer Contents Chapter 7: Lung Cancer... 1 Small Cell... 2 Good PS + Limited stage... 2 Cisplatin/etoposide... 2 Concurrent chemotherapy + XRT... 2 Good / Intermediate PS... 2 Carboplatin

More information

Page 1 of 6 Origination Date: 08/13 Revision Date(s): 12/13, 12/14, 04/2015 Developed By: Medical Criteria Committee Effective Date: 10/1/2013

Page 1 of 6 Origination Date: 08/13 Revision Date(s): 12/13, 12/14, 04/2015 Developed By: Medical Criteria Committee Effective Date: 10/1/2013 Moda Health Plan, Inc. Medical Necessity Criteria Subject: Alimta (pemetrexed) Page 1 of 6 Origination Date: 08/13 Revision Date(s): 12/13, 12/14, 04/2015 Developed By: Medical Criteria Committee Effective

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

Treatment of Malignant Pleural Mesothelioma: Is There a Benefit to Pleuropneumonectomy?

Treatment of Malignant Pleural Mesothelioma: Is There a Benefit to Pleuropneumonectomy? 55 Treatment of Malignant Pleural Mesothelioma: Is There a Benefit to Pleuropneumonectomy? Stacey Su, Michael T. Jaklitsch, and David J. Sugarbaker Malignant pleural mesothelioma (MPM) is a rare but highly

More information

Surgical treatment for malignant pleural mesothelioma: extrapleural pneumonectomy, pleurectomy/decortication or extended pleurectomy?

Surgical treatment for malignant pleural mesothelioma: extrapleural pneumonectomy, pleurectomy/decortication or extended pleurectomy? JBUON 2015; 20(2): 376-380 ISSN: 1107-0625, online ISSN: 2241-6293 www.jbuon.com E-mail: editorial_office@jbuon.com REVIEW ARTICLE Surgical treatment for malignant pleural mesothelioma: extrapleural pneumonectomy,

More information

Surgical Management of Malignant Pleural Mesothelioma: A Clinical Practice Guideline

Surgical Management of Malignant Pleural Mesothelioma: A Clinical Practice Guideline Evidence-based Series #7-14-2: Section 1 Surgical Management of Malignant Pleural Mesothelioma: A Clinical Practice Guideline D.E. Maziak, A. Gagliardi, A.E. Haynes, J.A. Mackay, W.K. Evans, and members

More information

Induction of Apoptosis by Intrapleural Perfusion Hyperthermo-Chemotherapy for Malignant Pleural Mesothelioma

Induction of Apoptosis by Intrapleural Perfusion Hyperthermo-Chemotherapy for Malignant Pleural Mesothelioma Original Article Induction of Apoptosis by Intrapleural Perfusion Hyperthermo-Chemotherapy for Malignant Pleural Mesothelioma Yasunori Matsuzaki, MD, Masaki Tomita, MD, Tetsuya Shimizu, MD, Masaki Hara,

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

PRODYNOV. Targeted Photodynamic Therapy of Ovarian Peritoneal Carcinomatosis ONCO-THAI. Image Assisted Laser Therapy for Oncology

PRODYNOV. Targeted Photodynamic Therapy of Ovarian Peritoneal Carcinomatosis ONCO-THAI. Image Assisted Laser Therapy for Oncology PRODYNOV Targeted Photodynamic Therapy of Ovarian Peritoneal Carcinomatosis ONCO-THAI Image Assisted Laser Therapy for Oncology Inserm ONCO-THAI «Image Assisted Laser Therapy for Oncology» Inserm ONCO-THAI

More information

Protein kinase C alpha expression and resistance to neo-adjuvant gemcitabine-containing chemotherapy in non-small cell lung cancer

Protein kinase C alpha expression and resistance to neo-adjuvant gemcitabine-containing chemotherapy in non-small cell lung cancer Protein kinase C alpha expression and resistance to neo-adjuvant gemcitabine-containing chemotherapy in non-small cell lung cancer Dan Vogl Lay Abstract Early stage non-small cell lung cancer can be cured

More information

Luis D. Carcorze Soto, MD PGY-3

Luis D. Carcorze Soto, MD PGY-3 Luis D. Carcorze Soto, MD PGY-3 Peritoneal Surface Malignancies Peritoneum Patient Selection Operative Technique HIPEC EPIC Primary: Primary Peritoneal Carcinoma Malignant Peritoneal Mesothelioma Metastatic:

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

Treatment of Mesothelioma with Radiotherapy

Treatment of Mesothelioma with Radiotherapy 41 Treatment of Mesothelioma with Radiotherapy Ryan P. Smith and Stephen M. Hahn General Principles of Radiation Therapy Radiation therapy is a therapeutic modality that uses ionizing radiation to treat

More information

FATAL PNEUMONITIS ASSOCIATED WITH INTENSITY-MODULATED RADIATION THERAPY FOR MESOTHELIOMA

FATAL PNEUMONITIS ASSOCIATED WITH INTENSITY-MODULATED RADIATION THERAPY FOR MESOTHELIOMA doi:10.1016/j.ijrobp.2006.03.012 Int. J. Radiation Oncology Biol. Phys., Vol. 65, No. 3, pp. 640 645, 2006 Copyright 2006 Elsevier Inc. Printed in the USA. All rights reserved 0360-3016/06/$ see front

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

Mesothelioma Applied Research Foundation www.curemeso.org

Mesothelioma Applied Research Foundation www.curemeso.org Mesothelioma Applied Research Foundation www.curemeso.org Board of Directors Michael Becich PhD Gen. Steven Blum Lee Krug MD David Ettinger MD Axel Ranier Richard Mosca Erica Iacono Terry Lynch Hanne Minz

More information

Chirurgia Avanzata Del Carcinoma Ovarico Nuove Strategie A Confronto Ovarian Cancer Advanced Surgery New Strategies in Comparison

Chirurgia Avanzata Del Carcinoma Ovarico Nuove Strategie A Confronto Ovarian Cancer Advanced Surgery New Strategies in Comparison Peritoneal dissection and intraperitoneal chemotherapy under hyperthermic conditions. If you select the right patients long-term survival can be achieved. Chirurgia Avanzata Del Carcinoma Ovarico Nuove

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

Small Cell Lung Cancer

Small Cell Lung Cancer Small Cell Lung Cancer Types of Lung Cancer Non-small cell carcinoma (NSCC) (87%) Adenocarcinoma (38%) Squamous cell (20%) Large cell (5%) Small cell carcinoma (13%) Small cell lung cancer is virtually

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

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

Targeted Therapy What the Surgeon Needs to Know

Targeted Therapy What the Surgeon Needs to Know Targeted Therapy What the Surgeon Needs to Know AATS Focus in Thoracic Surgery 2014 David R. Jones, M.D. Professor & Chief, Thoracic Surgery Memorial Sloan Kettering Cancer Center I have no disclosures

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

Radiation Therapy in the Treatment of

Radiation Therapy in the Treatment of Lung Cancer Radiation Therapy in the Treatment of Lung Cancer JMAJ 46(12): 537 541, 2003 Kazushige HAYAKAWA Professor and Chairman, Department of Radiology, Kitasato University School of Medicine Abstract:

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

Neoadjuvant Chemotherapy in Malignant Pleural Mesothelioma

Neoadjuvant Chemotherapy in Malignant Pleural Mesothelioma Chapter 5 Neoadjuvant Chemotherapy in Malignant Pleural Mesothelioma Giulia Pasello and Adolfo Favaretto Additional information is available at the end of the chapter http://dx.doi.org/10.5772/47880 1.

More information

Clinical Trials for Patients with

Clinical Trials for Patients with Clinical Trials for Patients with Malignant Pleural Mesothelioma Lee M. Krug, M.D. Memorial Sloan-Kettering Cancer Center New York, New York Challenges in MPM Clinical Trials Mesothelioma is a rare disease,

More information

GRANT APPLICATION FORM: ORGANISING AN ESO EDUCATIONAL EVENT

GRANT APPLICATION FORM: ORGANISING AN ESO EDUCATIONAL EVENT GRANT APPLICATION FORM: ORGANISING AN ESO EDUCATIONAL EVENT 1) TOPIC OF THE EVENT MALIGNANT PLEURAL DISEASE 2) SUGGESTED TITLE : Approach to Pleural Cancer: State-of-the-Art 3) TYPE OF EVENT Course Native

More information

The Need for Accurate Lung Cancer Staging

The Need for Accurate Lung Cancer Staging The Need for Accurate Lung Cancer Staging Peter Baik, DO Thoracic Surgery Cancer Treatment Centers of America Oklahoma Osteopathic Association 115th Annual Convention Financial Disclosures: None 2 Objectives

More information

Analysis of the effect of radiotherapy on malignant pleural mesothelioma when given on adjuvant or palliative basis

Analysis of the effect of radiotherapy on malignant pleural mesothelioma when given on adjuvant or palliative basis Analysis of the effect of radiotherapy on malignant pleural mesothelioma when given on adjuvant or palliative basis Hesham A. El Hossieny, MD 1, Fatma Aboulkasem, MD 2, Abdel Rahman M.,MD 3. (1) Department

More information

Population Pharmacokinetics and Pharmacodynamics of Cisplatinum During Intraperitoneal Chemohyperthermia Using a Closed Abdominal Procedure

Population Pharmacokinetics and Pharmacodynamics of Cisplatinum During Intraperitoneal Chemohyperthermia Using a Closed Abdominal Procedure Population Pharmacokinetics and Pharmacodynamics of Cisplatinum During Intraperitoneal Chemohyperthermia Using a Closed Abdominal Procedure Eddy Cotte, Brigitte Tranchand, Annie-Claude Beaujard, François-Noël

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

POLICY A. INDICATIONS

POLICY A. INDICATIONS Alimta (pemetrexed) Line(s) of Business: HMO; PPO; QUEST Integration Akamai Advantage Original Effective Date: 09/01/2007 Current Effective Date: 10/01/2015 POLICY A. INDICATIONS The indications below

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

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

Overview of Phase 1 Oncology Trials of Biologic Therapeutics

Overview of Phase 1 Oncology Trials of Biologic Therapeutics Overview of Phase 1 Oncology Trials of Biologic Therapeutics Susan Jerian, MD ONCORD, Inc. February 28, 2008 February 28, 2008 Phase 1 1 Assumptions and Ground Rules The goal is regulatory approval of

More information

PERITONEAL THERAPY IN OVARIAN CANCER, ROBERT P. EDWARDS, MD 1

PERITONEAL THERAPY IN OVARIAN CANCER, ROBERT P. EDWARDS, MD 1 PERITONEAL THERAPY IN OVARIAN CANCER, ROBERT P. EDWARDS, MD 1 Good morning, my name is Dr. Robert Edwards and I m going to be discussing peritoneal therapy in the treatment of women with ovarian cancer.

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

Table of Contents. Data Supplement 1: Summary of ASTRO Guideline Statements. Data Supplement 2: Definition of Terms

Table of Contents. Data Supplement 1: Summary of ASTRO Guideline Statements. Data Supplement 2: Definition of Terms Definitive and Adjuvant Radiotherapy in Locally Advanced Non-Small-Cell Lung Cancer: American Society of Clinical Oncology Clinical Practice Guideline Endorsement of the American Society for Radiation

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

Laparoscopic Hyperthermic Intraperitoneal Chemotherapy: Indications, Aims, and Results: A Systematic Review of the Literature

Laparoscopic Hyperthermic Intraperitoneal Chemotherapy: Indications, Aims, and Results: A Systematic Review of the Literature Ann Surg Oncol DOI 10.1245/s10434-012-2360-0 ORIGINAL ARTICLE REVIEW ARTICLE Laparoscopic Hyperthermic Intra Chemotherapy: Indications, Aims, and Results: A Systematic Review of the Literature Enrico Facchiano,

More information

Intracavitary chemotherapy is based on the doseresponse

Intracavitary chemotherapy is based on the doseresponse Cytoreductive Surgery and Intraoperative Hyperthermic Intrathoracic Chemotherapy in Patients With Malignant Pleural Mesothelioma or Pleural Metastases of Thymoma* Eelco de Bree, MD; Serge van Ruth, MD;

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

Peritoneal Mesothelioma: The Columbia Experience

Peritoneal Mesothelioma: The Columbia Experience 48 Peritoneal Mesothelioma: The Columbia Experience Jennifer A. Wagmiller, Mary-Louise Keohan, John A. Chabot, Karen Fountain, Mary Hesdorffer, and Robert N. Taub Malignant peritoneal mesothelioma is a

More information

WARNING, CONTRAINDICATIONS, WARNINGS AND PRECAUTIONS,

WARNING, CONTRAINDICATIONS, WARNINGS AND PRECAUTIONS, FACT SHEET BRANDED/GENERIC NAME: ABRAXANE for Injectable Suspension (paclitaxel protein-bound particles for injectable suspension) (albumin-bound) ABRAXANE is an albumin-bound form of paclitaxel with a

More information

Trimodality therapy for malignant pleural mesothelioma: results from an EORTC phase II multicentre trial

Trimodality therapy for malignant pleural mesothelioma: results from an EORTC phase II multicentre trial Eur Respir J 2010; 36: 1362 1369 DOI: 10.1183/09031936.00039510 CopyrightßERS 2010 Trimodality therapy for malignant pleural mesothelioma: results from an EORTC phase II multicentre trial P.E. Van Schil*,

More information

PET/CT Imaging in Lung Cancer

PET/CT Imaging in Lung Cancer PET/CT Imaging in Lung Cancer Mylene T. Truong, MD Mylene T. Truong M.D. Objectives To discuss the role of PET/CT in the staging of lung cancer To review the recommendations from American Society of Clinical

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

INTRAPERITONEAL HYPERTHERMIC CHEMOTHERAPY (IPHC) FOR PERITONEAL CARCINOMATOSIS AND MALIGNANT ASCITES. INFORMATION FOR PATIENTS AND FAMILY MEMBERS

INTRAPERITONEAL HYPERTHERMIC CHEMOTHERAPY (IPHC) FOR PERITONEAL CARCINOMATOSIS AND MALIGNANT ASCITES. INFORMATION FOR PATIENTS AND FAMILY MEMBERS INTRAPERITONEAL HYPERTHERMIC CHEMOTHERAPY (IPHC) FOR PERITONEAL CARCINOMATOSIS AND MALIGNANT ASCITES. INFORMATION FOR PATIENTS AND FAMILY MEMBERS Description of Treatment A major difficulty in treating

More information

Gemcitabine, Paclitaxel, and Trastuzumab in Metastatic Breast Cancer

Gemcitabine, Paclitaxel, and Trastuzumab in Metastatic Breast Cancer Gemcitabine, Paclitaxel, and Trastuzumab in Metastatic Breast Cancer Review Article [1] December 01, 2003 By George W. Sledge, Jr, MD [2] Gemcitabine (Gemzar) and paclitaxel show good activity as single

More information

Anti-PD1 Agents: Immunotherapy agents in the treatment of metastatic melanoma. Claire Vines, 2016 Pharm.D. Candidate

Anti-PD1 Agents: Immunotherapy agents in the treatment of metastatic melanoma. Claire Vines, 2016 Pharm.D. Candidate + Anti-PD1 Agents: Immunotherapy agents in the treatment of metastatic melanoma Claire Vines, 2016 Pharm.D. Candidate + Disclosure I have no conflicts of interest to disclose. + Objectives Summarize NCCN

More information

Multimodal therapy of malignant pleural mesothelioma: is the replacement of radical surgery imminent?

Multimodal therapy of malignant pleural mesothelioma: is the replacement of radical surgery imminent? Interactive CardioVascular and Thoracic Surgery Advance Access published November 21, 2012 Interactive CardioVascular and Thoracic Surgery (2012) 1 7 doi:10.1093/icvts/ivs465 ORIGINAL ARTICLE Multimodal

More information

Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC): Now and the Future

Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC): Now and the Future Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC): Now and the Future Mazin Al-kasspooles, MD Associate Professor of Surgery Division of Surgical Oncology Director, Regional Therapy

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

FAK INHIBITOR DEFACTINIB (VS-6063) TARGETS MESOTHELIOMA CANCER STEM CELLS. Jonathan Pachter, Ph.D.

FAK INHIBITOR DEFACTINIB (VS-6063) TARGETS MESOTHELIOMA CANCER STEM CELLS. Jonathan Pachter, Ph.D. FAK INHIBITOR DEFACTINIB (VS-6063) TARGETS MESOTHELIOMA CANCER STEM CELLS Rationale for maintenance therapy after conventional therapy Jonathan Pachter, Ph.D. Vice President of Research, Verastem, Inc.

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

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

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

Update on Clinical Trials and Foundation Funded Grants

Update on Clinical Trials and Foundation Funded Grants Update on Clinical Trials and Foundation Funded Grants Mary Hesdorffer, MS, APRN-BC Medical Liaison Meso Foundation www.curemeso.org Delivering the Diagnosis Delivering the Diagnosis Day 1 Taking control

More information

Low dose capecitabine is effective and relatively nontoxic in breast cancer treatment.

Low dose capecitabine is effective and relatively nontoxic in breast cancer treatment. 1 Low dose capecitabine is effective and relatively nontoxic in breast cancer treatment. John T. Carpenter, M.D. University of Alabama at Birmingham NP 2508 1720 Second Avenue South Birmingham, AL 35294-3300

More information

Lung Cancer Treatment Guidelines

Lung Cancer Treatment Guidelines Updated June 2014 Derived and updated by consensus of members of the Providence Thoracic Oncology Program with the aid of evidence-based National Comprehensive Cancer Network (NCCN) national guidelines,

More information

EVALUATION/PRIORITIZATION CRITERIA: C, L, R, S *to meet requirement 1

EVALUATION/PRIORITIZATION CRITERIA: C, L, R, S *to meet requirement 1 COMPENDIA TRANSPARENCY TRACKING FORM DATE: MAY 2015 PACKET: 111 DRUG: INDICATION: Vinorelbine Tartrate Malignant pleural mesothelioma COMPENDIA TRANSPARENCY REQUIREMENTS 1 Provide criteria used to evaluate/prioritize

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

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

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

BCCA Protocol Summary for Palliative Therapy for Metastatic Breast Cancer using Trastuzumab Emtansine (KADCYLA)

BCCA Protocol Summary for Palliative Therapy for Metastatic Breast Cancer using Trastuzumab Emtansine (KADCYLA) BCCA Protocol Summary for Palliative Therapy for Metastatic Breast Cancer using Trastuzumab Emtansine (KADCYLA) Protocol Code Tumour Group Contact Physician UBRAVKAD Breast Dr Stephen Chia ELIGIBILITY:

More information