We Can Help

The costs of mesothelioma can be overwhelming. They can include income loss, expensive treatments that may not be covered by health insurance, plus pain and suffering for you and for your family. Because the disease is preventable – and because it is usually caused by someone else’s negligence – legal options may be available to help regain these costs. Asbestos lawyers focus their practice on knowledgeably and effectively bringing to justice companies that exposed employees and the public to asbestos products. A mesothelioma attorney can help you consider your options and file a claim against the company responsible for your asbestos-related illness. More than one company may be responsible. A mesothelioma attorney identifies all companies at fault. Mesothelioma lawsuits have helped thousands of people receive financial assistance. A lawsuit can result in much-needed money to help reduce financial hardships during an illness and can also provide a more stable future for your loved ones. A lawyer specializing in asbestos litigation can help you seek compensation for expenses related to illness caused by asbestos exposure.

Mesothelioma Specialty Centers Factor in 2021 Best Hospital Rankings

University of Texas MD Anderson Cancer Center in Houston is No. 1 for the seventh consecutive year on the prestigious U.S. News & World Report Best Hospitals for Cancer list.

The annual cancer rankings were included in the media company’s recently published Best Hospitals 2022 guidebook. Cancer is one of the 15 specialties for which hospitals in the U.S. were ranked.

Other hospitals in the top five are: Memorial Sloan Kettering Cancer Center in New York City; Mayo Clinic in Rochester, Minnesota; Dana-Farber/Brigham and Women’s Hospital in Boston and the Cleveland Clinic Cancer Center.

Mesothelioma specialty programs contributed to the high rankings of the top five, where doctors have access to the most up-to-date diagnostic and treatment advances. They also see this rare cancer more often than most.

“These rankings are meant for patients with life-threatening or rare conditions who need a hospital that excels in treating complex, high-risk cases,” the study authors wrote. “These rankings are helpful if you’re looking for information about a rare condition or difficult diagnosis that isn’t treated at many facilities.”

U.S. News & World Report Top 10 Cancer Centers

The following cancer centers placed in the top 10 on the U.S. News & World Report Best Hospitals for Cancer list, with a tie for sixth place.

  1. University of Texas MD Anderson Cancer Center, Houston
  2. Memorial Sloan Kettering Cancer Center, New York City
  3. Mayo Clinic, Rochester, Minnesota
  4. Dana-Farber/Brigham and Women’s Cancer Center, Boston
  5. Cleveland Clinic, Cleveland
  6. Johns Hopkins Hospital, Baltimore (tied for 6th)
  7. Northwestern Memorial Hospital, Chicago (tied for 6th)
  8. UCLA Medical Center, Los Angeles
  9. Cedars-Sinai Medical Center, Los Angeles
  10. Hospitals of the University of Pennsylvania-Penn Presbyterian, Philadelphia

There were only a few changes in the rankings from the year before. Johns Hopkins dropped from fourth to a tie for sixth, while Dana-Farber/Brigham and Women’s rose from sixth to fourth.

Both UCLA Medical Center and University of Pennsylvania-Penn Presbyterian moved into the top 10 after falling out the previous year.

Rankings Are Key for Treatment of Rare Cancers

Mesothelioma, which is caused by exposure to asbestos, is diagnosed in an estimated 3,000 patients annually. Finding a staff experienced in treating this cancer with a multidisciplinary approach can help patients extend their lives significantly, well beyond the median survival of 12 months.

These centers are often where the cutting-edge clinical trials can be found and where treatment advances are made. MD Anderson, for example, has almost 20 mesothelioma clinical trials in the active or recruiting phase.

“Our evaluations are relevant to patients with mesothelioma,” Ben Harder, managing editor and chief of health analysis at U.S. News and World Report, told The Mesothelioma Center at Asbestos.com. “These rankings identify the top centers for complex oncology care that other hospitals might see rarely, if ever.”

High Ranking Means Medical Excellence

The top 10 cancer centers in the rankings are filled with specialists well known within the mesothelioma community.

Thoracic surgeons such as Dr. Robert Cameron (UCLA), Dr. Abraham Lebenthal (Dana-Farber), Dr. David Rice (MD Anderson) and Dr. Sunil Singhal (University of Pennsylvania) are leaders in the field.

Oncologists Dr. Prasad Adusumilli (Memorial Sloan Kettering), Dr. James Stevenson (Cleveland Clinic), Dr. Aaron Mansfield (Mayo Clinic) and Dr. Anne Tsao (MD Anderson) have been lauded as both clinicians and researchers who have improved mesothelioma treatment with their work.

A second tier of 10 treatment centers rounds out the top 20 on the rankings list. It includes UCSF Medical Center in San Francisco, UPMC in Pittsburgh, Massachusetts General Hospital in Boston and City of Hope Comprehensive Cancer Center in Duarte, California. These centers also have a solid reputation for excellent mesothelioma treatment.

Four Categories Determine Best Cancer Hospital Rankings

Rankings were based on a wide range of factors, but included four broad categories:

  • Outcomes and Patient Experience
  • Key Programs and Staff
  • Professional Recognition
  • Conditions/Procedures Applicable to Cancer

The Mayo Clinic, Cleveland Clinic, UCLA Medical Center and Johns Hopkins ranked 1 through 4 respectively on the Best Hospitals Honor Roll, exhibiting their excellence beyond treating cancer.

Other specialty categories that were part of the overall rankings included Cardiology & Heart Surgery, Gastroenterology & GI Surgery, Neurology & Neurosurgery, Orthopedics, Rheumatology, Diabetes & Endocrinology.

More than 4,750 hospitals across the country were evaluated and 175 were nationally ranked in at least one specialty.

To qualify for consideration in one of the specialty categories, a hospital had to satisfy at least one of four criteria:

  • Must be a teaching hospital
  • Affiliated with a medical school
  • At least 200 staffed beds or at least 100 beds
  • Have four technologies associated with high-quality care

Impact from the COVID-19 pandemic was not factored into the ranking, although it will be used for the 2022-23 evaluations expected to be released in July.

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NCI Opens New Immunotherapy Clinical Trial for Mesothelioma

The National Cancer Institute has opened a promising clinical trial aimed at increasing the effectiveness of immunotherapy treatment for patients with unresectable malignant mesothelioma.

This latest study involves combining LMB-100, a manmade protein designed to kill cancer cells, with ipilimumab, an immunotherapy drug recently approved for use by the U.S. Food and Drug Administration. Ipilimumab is also known by the brand name Yervoy.

Although immunotherapy has worked well with some cancers, its effectiveness in treating mesothelioma has been selective and has lacked sustainability.

This new study combination has been especially effective in earlier laboratory testing, leading to the phase I clinical trial for both pleural and peritoneal mesothelioma.

“We know it works in mice,” principal investigator Dr. Raffit Hassan told The Mesothelioma Center at Asbestos.com. “Whether it works in humans, only time will tell. We’ll have to see. The goal is making these tumors more responsive to immunotherapy.”

Hassan is chief of the Thoracic and GI Malignancies Branch at the National Institutes of Health Clinical Center in Bethesda, Maryland, where the trial has begun. He has been instrumental in recent mesothelioma treatment advances.

Combination Could Offer Viable Second-Line Option

The trial is designed for patients with inoperable disease, where both standard chemotherapy and immunotherapy were used earlier before tumor growth returned. It is for confirmed cases of epithelial or biphasic mesothelioma, the most common types of mesothelioma.

“For patients today, there really is no, or very limited, options after chemotherapy and immunotherapy have failed,” Hassan said. “This study offers a reasonable chance of benefit. It would be nice to see if these patients again respond to immunotherapy.”

The FDA approved Opdivo and Yervoy, an immunotherapy combination, for first-line treatment of pleural mesothelioma in 2020. It was the first new systemic approval in more than 16 years. However, it only increased the median overall survival time from 14.1 months to 18.1 months, when compared to standard chemotherapy.

Doctor conducting medical testing using lab equipment
Find Immunotherapy Clinical Trials
Learn how to access mesothelioma clinical trials for immunotherapy.

LMB-100 Trial Follows Earlier Study

This latest mesothelioma trial is building on an earlier study at the National Cancer Institute involving pembrolizumab (Keytruda), another immunotherapy drug with a different way of delivering LMB-100.

The earlier trial used systemic delivery. This latest trial involves an intratumor injection of the drug, a novel method that will be watched closely for its potential to better stimulate a more durable immune system response.

LMB-100 works by targeting mesothelin, a tumor-associated antigen that is found highly expressed on the surface of many different types of tumors, including pancreatic, ovarian, lung and mesothelioma.

“In mice, you can completely get rid of the tumors with this delivery. Not only the ones injected, but those not injected,” Hassan said. “It’s one reason for this clinical trial to see if we can achieve the same in patients.”

Researchers Test Safe Dosage Levels   

Patients in the trial will receive the LMB-100 injections into their tumors on days 1 and 4 for up to two 21-day cycles. Those will be combined with up to four doses of ipilimumab systemically.

Through the trial, researchers expect to identify the safest and best dosage levels for both LMB-100 and ipilimumab.

Ipilimumab is known as a checkpoint inhibitor immunotherapy, which helps the body’s immune system attack cancer cells.

LMB-100 was designed originally to broaden immunotherapy effectiveness. Dr. Ira Pastan, an NCI scientist, led the drug’s development.

“There is hope on the horizon – more options today for patients with mesothelioma than there were a few years ago,” Hassan said. “We’ll just have to see where this goes. Progress is being made.”

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Clinical Trials Lead to Promising Updates in Mesothelioma Immunotherapy

Researchers have made significant progress in mesothelioma treatment advancements recently, including promising work with immunotherapy.

The first U.S. Food and Drug Administration-approved combination immunotherapy for mesothelioma, nivolumab and ipilimumab, known by brand names Opdivo and Yervoy, has been effective for many patients.

In September 2021, the European Society for Medical Oncology presented study data showing a three-year survival rate of 23% for mesothelioma patients on Opdivo and Yervoy. By comparison, the three-year survival rate for chemotherapy patients was 15%.

However, some patients cannot receive immunotherapy drugs due to chronic medical conditions or a lack of specific biomarkers. Immunotherapy is also not a final solution to mesothelioma. For example, Opdivo and Yervoy are only available as a first-line treatment for mesothelioma patients, not if cancer returns after prior treatment.

In many cases, current immunotherapy can improve survival compared to traditional methods, but there’s still room for improvement. The most effective treatments for mesothelioma include a multimodal approach combining immunotherapy with surgery, chemotherapy, radiation or other procedures.

5 Promising Mesothelioma Immunotherapy Advancements

In November, Dr. Anna Nowak, a researcher at the Institute for Respiratory Health in Perth, Western Australia, published her team’s report on updates to the latest immunotherapy trials for mesothelioma.

Nowak’s focus is immune checkpoint inhibitor therapy, the same class of drugs as Opdivo and Yervoy. Also known as checkpoint blockades, these treatments hold significant potential for improving pleural mesothelioma prognosis and life expectancy.

“The most impressive advancement for checkpoint blockade has been the demonstration that for people with sarcomatoid and biphasic mesothelioma, we can double survival with the combination of ipilimumab and nivolumab,” Nowak told The Mesothelioma Center at Asbestos.com.

This recent study provided an overview of recent clinical trials for malignant pleural mesothelioma and highlighted the most promising new advancements in immunotherapy.

Immunotherapy Advancements
  1. Second-Line Nivolumab: The randomized CONFIRM study recruited 332 participants who had failed one or two previous lines of therapy. Both pleural and peritoneal mesothelioma were eligible. Second-line nivolumab alone improved overall survival from 6.9 months to 10.2 months compared to the placebo group. Median progression-free survival was three months.
  2. Anti-CTL4 and Anti-PD-L1 Combinations: The phase II NIBITMeso trial tested the anti-CTLA4 agent tremelimumab with the anti-PD-L1 agent durvalumab (Imfinzi) as a first-line or second-line therapy. Of the 40 participants, 65% of patients had disease control. The INITIATE study tested first-line nivolumab and ipilimumab in 38 patients, with 68% showing disease control.
  3. Chemoimmunotherapy with Checkpoint Blockade: Results of the PrE0505 study support the potential of combining chemotherapy with checkpoint blockade or inhibitors. This 55-patient study combined the chemotherapy drugs cisplatin and pemetrexed with durvalumab. The median overall survival was 20.4 months, and the median progression-free survival was 6.7 months.
  4. Biomarker Testing for Checkpoint Blockade: Recent evidence suggests that testing for PD-L1 biomarker expression is not a good indicator of success for anti-PD-L1 immunotherapies such as pembrolizumab (Keytruda). However, new studies show that monitoring PD-L1 with radioactive tracers provides a more practical, real-time level of biomarker activity.
  5. Proper Sequencing of Immunotherapies: There is limited data on immunotherapy patients who receive treatment before or after other therapies. However, the CheckMate 743 trial indicated that neoadjuvant use could effectively reduce tumor bulk before surgery for mesothelioma. Several pilot clinical trials are examining both adjuvant and neoadjuvant checkpoint blockade.

Some mesothelioma cell types, such as epithelioid, respond less well to immunotherapy. Nowak believes more research will reveal new options for these patients.

“This is why we need to support the clinical trials that will answer this question,” she said. “I am optimistic that the combination of chemotherapy and checkpoint blockade may do for epithelioid mesothelioma what dual checkpoint blockade has done for non-epithelioid mesothelioma.” 

Anti-Angiogenesis Becoming a New Standard for Immunotherapy

Scientists continue to study new drugs and mesothelioma treatments that improve overall survival and safety for more people. A 2021 study in the Journal of Cancer Metastasis and Treatment recently evaluated several ways mesothelioma immunotherapy is evolving.

In addition to Opdivo and Yervoy for unresectable malignant pleural mesothelioma, scientists are researching other immunotherapy combinations. One method that has shown effectiveness is anti-angiogenesis, a type of immunotherapy that targets blood vessels.

Angiogenesis is the process of new blood vessel formation. In cancer, tumors form blood vessels to use oxygen for growth and metastasis. Anti-angiogenesis medications inhibit vascular endothelial growth factors, or VEGF. These drugs prevent new blood vessel growth, effectively starving tumors of oxygen and nutrients.

A popular VEGF inhibitor for mesothelioma, bevacizumab, was recently part of a large, phase III randomized controlled trial conducted by the French thoracic oncology cooperative group IFCT. This study recruited patients with unresectable pleural mesothelioma who had not received prior chemotherapy.

The primary endpoint of median overall survival was significantly longer with the addition of bevacizumab to chemotherapy at 18.8 months versus 16.1 months with chemotherapy alone. However, adverse events such as hypertension and bleeding were more common in the bevacizumab group.

More recently, studies such as the phase II RAMSES trial in 2020 have shown promising results for combining anti-VEGF medication with chemotherapy as a second-line treatment. The addition of the VEGF inhibitor ramucirumab significantly improved median overall survival to 13.8 months compared to 7.5 months for chemotherapy alone.

Future clinical trials will undoubtedly build on the success of current immunotherapies, including VEGF-inhibitors, checkpoint blockades and more. In 2022, researchers will hopefully find ways to improve the effectiveness, response rate and safety of these therapies for mesothelioma patients.

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Mesothelioma Clinical Trial to Involve Drug Studied for COVID-19

A novel phase II clinical trial for malignant mesothelioma is expected to open soon and involve a versatile, biological drug already showing promise in treating severe cases of COVID-19.

Oncotelic Therapeutics Inc., an innovative, immunotherapy/oncology company in Agoura Hills, California, hopes to open the mesothelioma clinical trial by March at a dozen prominent U.S. treatment centers, including the Cleveland Clinic Cancer Center, University of Pennsylvania Medicine in Philadelphia and Fred Hutchinson Cancer Research Center in Seattle.

“We’re excited about the potential. There is a huge unmet medical need with mesothelioma. The hope is that we can use this to increase the response to checkpoint inhibitors,” Dr. Anthony Maida, chief clinical officer at Oncotelic, told The Mesothelioma Center at Asbestos.com. “The goal is to help these patients live longer, better lives.”

OT-101 is the name of the biologic, made from complex molecules and manufactured using living microorganisms. It works by inhibiting transforming growth factor beta (TGF-beta), a protein that suppresses a patient’s own immune system and allows tumors to flourish.

TGF-beta is expressed in many cancers, but in particularly high levels with mesothelioma tumors.

“We are essentially trying to suppress the suppressor,” Maida said.

Drug Helps the Immune System Work

Both tumor cells and the coronavirus induce TGF-beta as part of their immune evasion mechanism, potentially making OT-101 impactful with COVID and cancers.

The OT-101 treatment already showed positive activity in a recently completed phase II clinical trial involving patients hospitalized with severe COVID-19 symptoms.

It also will be tested soon with glioblastoma, lung and colorectal cancers, according to Oncotelic Therapeutics.

OT-101 will be used in the upcoming mesothelioma study in combination with checkpoint inhibitor drugs, the most common of which are pembrolizumab and nivolumab, both already being used in various ways to treat mesothelioma.

Doctor conducting medical testing using lab equipment
Clinical Trials for Mesothelioma Patients
Get help improving your prognosis by finding a mesothelioma clinical trial today.

Improving Checkpoint Inhibitors

The effectiveness of checkpoint inhibitor drugs with mesothelioma has been inconsistent. It has worked exceptionally well, but only for a small percentage of patients.

“What we’re hoping is that by combining with checkpoint inhibitors, we will see a better response in more patients. We would love to get the 20%-25% effectiveness that there is now to 50% effectiveness,” Maida said. “We can help these patients.”

The FDA recently approved the checkpoint inhibitor combination of nivolumab and ipilimumab, also known by brand names Opdivo and Yervoy, for first-line treatment of pleural mesothelioma.

The median survival improvement for patients, though, was only modest for the most common subtype of disease when compared to standard chemotherapy.

That’s where OT-101 could make a difference if proven effective in early clinical trials.

“The major reason for the failure of these checkpoint inhibitor drugs with mesothelioma is the high levels of [TGF-beta],” Maida said.

OT-101 Trial Will Boost Research Efforts

The upcoming clinical trial will not only test the influence of OT-101 on the checkpoint inhibitors but will be used to help identify more predictive biomarkers for TGF-beta.

CAR T-cell therapy, for example, which involves the modification of a patient’s own T cells, has been shown in the laboratory to benefit greatly from the inhibition of the TGF-beta protein. The long-range hope is to find better ways to counter defense mechanisms used by the tumor cells.

Mesothelioma is a rare cancer with no definitive cure, diagnosed in an estimated 3,000 people within the U.S. annually. It is most often caused by the inhalation of toxic asbestos fibers.

“This is the first of a series of planned clinical trials in patients with various solid tumors evaluating clinical benefit, while also assessing a host of parameters associated with changes in the tumor microenvironment,” Maida said. “We’re moving forward.”

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Court Deals Blow to Johnson & Johnson Bankruptcy Plan for Talc Cases

A federal judge in North Carolina delivered a major setback to Johnson & Johnson and its controversial plan to unload all talc-related litigation in bankruptcy court through a recently-created subsidiary.

Bankruptcy Judge Craig Whitley said he was “obligated” to move the case from North Carolina to New Jersey, where Johnson & Johnson is headquartered and thousands of the talc-related lawsuits are already pending.

The move from North Carolina to New Jersey takes J&J from a jurisdiction considered favorable to its bankruptcy strategy to one that is unfavorable, based upon past cases.

Johnson & Johnson is facing a multitude of lawsuits – more than 36,000 – linked to claims that its asbestos-contaminated baby powder has caused a variety of malignancies, including ovarian and mesothelioma cancer.

Settled claims and jury verdicts have already cost the company an estimated $3.5 billion, along with another $1 billion in defense costs. Its Chapter 11 bankruptcy plan could save billions in the future by creating a shield that would stop all future litigation.

Johnson & Johnson is considered one of America’s most profitable companies, with a market share of more than $450 billion.

New Subsidiary Meant to Shoulder Talc Liabilities

J&J had steered the federal bankruptcy case to Charlotte, North Carolina, through its newly created subsidiary, LTL Management LLC. It created the subsidiary earlier this year in Texas, a state that allows splitting corporate assets from liabilities. It then moved the subsidiary to North Carolina and quickly filed for bankruptcy.

According to court documents from its bankruptcy petition, LTL Management listed its worth at $10 billion, along with $10 billion in liabilities.

“Thankfully, Judge Whitley saw through what J&J was trying to do. I believe their [bankruptcy] petition will be rejected in New Jersey,” Daniel Wasserberg, a New York City attorney who specializes in asbestos litigation, told The Mesothelioma Center at Asbestos.com. “J&J will return to the tort system where they belong, and they will be forced to face the music for their deadly talcum powder. This was an extremely expensive miscalculation by J&J.”

Other companies have used similar tactics in the past to avoid liabilities. This attracted the attention of Congress, which is considering legislation to change the rules governing Chapter 11 bankruptcy filings.

In July, a U.S. House of Representatives oversight committee sent a letter to Johnson & Johnson urging it to drop the bankruptcy maneuver and requesting answers about its strategy.

Talc Lawsuits Temporarily Suspended

During the court hearing on Wednesday, Whitley agreed to a 60-day halt on all talc-related lawsuits against J&J, pending the federal bankruptcy court ruling that will now come from New Jersey.

Attorneys throughout the country representing plaintiffs in cases against J&J applauded the move to New Jersey, where the petition for bankruptcy protection is expected to be denied.

LTL Management issued a statement in response to the order that moved the case from North Carolina to New Jersey.

“Although we believe this case was properly venued in North Carolina, we will continue to work with all parties to seek an efficient and equitable resolution,” the statement said.

Under bankruptcy protection, all legal proceedings in state and federal courts would be halted and eventually would come before a single bankruptcy judge. It would allow J&J to separate its immense profitability from all potential liabilities, which would be considerably smaller under bankruptcy protection. The court would determine the amount to be put into a trust fund, from which current and future claimants would be compensated.

The first case brought against J&J involving talc came in 2014. Until 2020, J&J had litigated many of the cases in court and defended the safety of its products. Although J&J won many of the cases, it also lost some very big ones.

Earlier this year, the U.S. Supreme Court rejected a request by J&J to overturn an earlier $2.1 billion judgement in Missouri involving 22 women with ovarian cancer.

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Immunotherapy-chemotherapy treatment coupled with in-depth genomic analyses leads to improved survival for patients with mesothelioma

Combining the immunotherapy agent durvalumab with the chemotherapy agents pemetrexed and cisplatin or carboplatin may provide a new treatment option for patients who have inoperable pleural mesothelioma, a cancer of the tissues lining the lungs, according to a phase II clinical trial.

University of Vermont Study Opens New Door for Mesothelioma Treatment

Researchers at the University of Vermont Cancer Center have uncovered a new approach to the treatment of malignant pleural mesothelioma, sparking a clinical trial that has opened with considerable anticipation.

The trial involves RSO-021, a novel drug that works by inhibiting a tumor cell’s ability to manage its own toxic waste byproduct.

“The key to the therapy is the universal vulnerability present in these cancer cells that our therapeutic approach interferes with,” University of Vermont professor Brian Cunniff, the study’s lead researcher, told The Mesothelioma Center at Asbestos.com. “These tumor cells generate a lot of waste, and they have to manage that waste appropriately, or it can become toxic.

“We’re killing them from the inside out, essentially,” Cunniff said. “It’s like putting a potato into the tailpipe. The tumor cells choke on their own exhaust.”

Clinical Trial Is First in Humans for RSO-021

RSO-021 therapy has been effective in significantly reducing mesothelioma tumor burden in laboratory and mice models through the inhibition of enzymes in the antioxidant signaling network.

“There has been a lot of research around the intervention that we’re testing, but all with preclinical models,” Cunniff said. “This will be a first in-human study. There is a lot of optimism for this approach, based upon the mechanism of action of this drug. We think we’ve developed a specific therapy that could be very beneficial.”

The phase I/II clinical trial, which will test the safety and efficacy of RSO-021, has begun recruiting patients at eight sites throughout the United Kingdom. The hope is to move into the U.S. in 2022.

Mesothelioma patients will be treated with direct application of the drug to the tumor site through a pleural catheter, a common device used in patients with mesothelioma.

RS Oncology, a small preclinical biotechnical company in Boston focusing on novel therapies and pleural diseases, is sponsoring the study.

University of Vermont professor Brian Cunniff
University of Vermont professor Brian Cunniff is the lead researcher on the first in-human clinical trial of RSO-021, a potential mesothelioma therapy.

University of Vermont Plays Key Role

Cunniff first discovered the potential of the novel therapy in 2007 as a graduate student at the University of Vermont. He is now an assistant professor in the school’s Department of Pathology and Laboratory Medicine.

Cunniff has been working for the past four years in collaboration with RS Oncology and Wake Forest University School of Medicine to prove the anti-tumor activity discovered in his lab and prepare parameters for the potentially groundbreaking clinical trial.

Their work is a prime example of how long the developmental process can take in advancing new treatments for rare diseases.

The Cunniff Lab at the University of Vermont will serve as the primary site for gathering patient samples and translational research within the trial.

Advances in Mesothelioma Treatment Needed

There is no definitive cure for pleural mesothelioma, which is caused almost exclusively by exposure to asbestos, and treatment advancements have been slow.

Although the FDA recently approved an immunotherapy combination for treatment, its effectiveness remains limited. It was the first systemic approval for mesothelioma in 16 years.

While aggressive surgery has helped some patients survive longer, less than a third of those diagnosed even qualify for that option. The five-year survival rate has been estimated at less than 10% of those diagnosed.

“Any new, promising approach for this cancer is a reason for optimism,” Cunniff said. “It’s a very aggressive tumor with very few options in treating it.”

While his research was centered around pleural mesothelioma, Cunniff said there has been considerable data to suggest the approach could provide help with other cancers as well.

“We’re excited about RSO-021 as a novel metabolic therapy,” said Jarrett Duncan, RS Oncology CEO. “This clinical trial is an important step in improving treatment. It shows tremendous promise.”

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Study Supports Opdivo as Second-Line Mesothelioma Treatment

When the effectiveness of first-line chemotherapy fails and malignant mesothelioma returns, more patients could soon turn with confidence to a proven, second-line treatment.

The first phase III, placebo-controlled, double-blind clinical trial studying the safety and efficacy of Opdivo, the immunotherapy drug known generically as nivolumab, has raised the level of confidence in this option for patients with relapsed disease.

“The evidence is robust, the survival significant,” Dr. Dean Fennell, chair of Thoracic Medical Oncology, University of Leicester and University Hospitals in the United Kingdom, told The Mesothelioma Center at Asbestos.com. “This was the first trial to show evidence of real improvement in a relapsed setting.”

Fennell, former president of the International Mesothelioma Interest Group, was the principal investigator and lead author of the study. The Lancet Oncology published the results online in October.

Opdivo/Yervoy Combination in Use

The U.S. Food and Drug Administration and the European Commission have already approved the combination of Opdivo and Yervoy, another immunotherapy drug, for first-line treatment of unresectable pleural mesothelioma, although its use is still far from universal. The most effective treatment combination for pleural mesothelioma continues to be the multidisciplinary regimen of surgery, chemotherapy and radiation.

Debate over the best second-line treatment continues, but this latest clinical trial, which has built on earlier phase II studies, could change the direction in favor of Opdivo.

The trial involved 332 patients spread across 24 hospitals throughout the United Kingdom. There were no restrictions on the number of previous therapies given, although all had received at least one platinum-based chemotherapy treatment.

Patients were given either Opdivo or a placebo every two weeks until disease progression, withdrawal from treatment, or for a maximum of 12 months. The median follow-up was 11.6 months, with 33% of the patients receiving the placebo.

Survival Numbers Could Increase

In the study, median progression-free survival after treatment with nivolumab was three months compared to 1.8 months for those receiving the placebo. The median overall survival was 10.2 months compared to 6.9 months in the placebo group.

Fennell expects the difference in median overall survival to grow in the coming months.

“This was preliminary data. The study was underpowered for final results,” he said. “Some of the patients are still out there, so those survival numbers will increase.”

Progression-free survival at one year for those getting Opdivo was 14.2% and overall survival was 43.4%.

Fennell also thinks the results will continue to build on the growing belief that Opdivo will be included in more effective immunotherapy combinations beyond Yervoy, known generically as ipilimumab.

“I think a number of combinations will be explored, and there is no reason why, with mesothelioma, that we can’t provide better second-line options,” he said. “There is more to come.”

Some Side Effects Prove Limiting

Opdivo has been approved by the FDA for a variety of cancers, including melanoma. It also is used today for lung cancer, Hodgkin lymphoma, head and neck cancers and high-risk urothelial carcinoma, with the latest approval in August.

Opdivo works with mesothelioma by blocking the protein PD-1, which stops a patient’s own immune system from attacking the tumor cells. The drug has shown an ability to help the immune system work more effectively, but that duration is limited.

Side effects also can be an issue, according to the study. Adverse events led to treatment discontinuation in 14% of patients receiving Opdivo compared to 3% of those receiving the placebo.

The most common problems leading to discontinuation were infusion-related reactions and diarrhea. Serious adverse events occurred in 41% of those in the Opdivo group and 44% of those in the placebo group.

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New California Law Could Benefit Mesothelioma Plaintiffs

A recently amended California law will now allow the estates of deceased plaintiffs, including mesothelioma patients, to collect pain and suffering damages.

Previously, only the person who sustained bodily injury could recover pain and suffering damages. These damages are often the largest sums of money at stake in many mesothelioma lawsuits. When it becomes law on Jan. 1, Senate Bill 447 will expand the range of recoverable damages and eliminate long-standing restrictions.

The amended statute, signed Oct. 1, allows California to join 45 other states that permit the recovery of noneconomic damages for an assortment of personal injury cases after a plaintiff dies. Florida, Idaho, Colorado and Arizona are the only states that still prohibit the practice.

“This is a giant step forward for mesothelioma victims in California,” San Francisco-based attorney Jennifer Alesio, shareholder at the Simmons Hanly Conroy law firm, told The Mesothelioma Center at Asbestos.com. “Prior to its passage, asbestos companies received a ‘death discount’ if a mesothelioma victim passed away prior to trial.”

Law Provides More Help to Families

Alesio, who focuses her practice on mesothelioma and other cases related to asbestos, has earned a reputation as a leader in the field with her empathetic approach to clients, her tenacity in the courtroom and the settlements and verdicts she has obtained.

“The legislature heard heartbreaking testimony from families of asbestos victims who passed away before their day in court,” she said. “The new law corrects this injustice by preserving the victim’s human suffering damages.”

In the past, companies being sued for exposing plaintiffs to the toxic asbestos that causes mesothelioma cancer often attempted to delay court trial dates, knowing they could save millions of dollars if plaintiffs died before a verdict was reached. That incentive to delay has been eliminated.

Mesothelioma patients are typically older and sicker than many other lawsuit plaintiffs. The latency period between exposure to asbestos and diagnosis of disease can be as long as 50 years. Once diagnosed, the median survival is less than a year.

COVID-19 Pandemic Compounded the Problem

The COVID-19 pandemic, which led to court-related shutdowns and further delays, accentuated the need for the amended law. Terminally ill patients in California may petition the court for an expedited trial within 120 days, but the pandemic delayed many of those cases.

Consumer Attorneys of California, a professional organization and advocacy group, co-sponsored the bill that was authored by California state Sen. John Laird.

“California is one of only five states in the entire nation that rewards defendants for prolonging court procedures – leaving victims unable to obtain justice,” Laird said. “SB 447 will end decades-old injustice by finally extending a victim’s right, and the right of their loved ones, to pursue accountability for human suffering – even if they die prior to case resolution.”

According to an investigation by NBCBayArea.com, the restrictions on pain and suffering awards were put in place in the 1960s at the urging of insurance companies trying to limit their payouts.

In a compromise with opponents, the new law comes with an expiration date of Jan. 1, 2026.

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Johnson & Johnson Sending Talc Cases to Bankruptcy Court

As expected, Johnson & Johnson has unloaded its burgeoning talc-related liabilities on a new subsidiary that filed for Chapter 11 bankruptcy protection on Oct. 14.

The controversial move, which confirmed the fears of many personal injury attorneys, is an attempt by J&J to more easily resolve the thousands of current and future lawsuits claiming that its talc products have caused serious medical problems, including ovarian and mesothelioma cancers.

Most of the claims contend that talc in the products was contaminated with toxic asbestos fibers.

The filing, in U.S. Bankruptcy Court in the Western District of North Carolina, puts an immediate halt to all legal proceedings in state and federal courts and eventually will move all unsettled talc lawsuits before a single bankruptcy judge.

LTL Management LLC is the newly created subsidiary that will inherit the cases, allowing J&J to separate its immense profitability from its potential liabilities, which will be considerably smaller under bankruptcy protection. Johnson & Johnson is expected to save billions of dollars long term.

Lower Settlements Predicted After J&J’s Action

A panel of lawyers representing talc claimants had tried unsuccessfully to block the corporate restructuring. A U.S. Bankruptcy Court in the District of Delaware refused to issue a restraining order against J&J in August.

The filing is expected to pressure claimants to accept lower settlements than they would have before, stop jury verdicts and avoid any excessive payouts.

“This is crazy. What’s happening here is a corporate crime, the likes of which we have never seen,” attorney Daniel Wasserberg, a New York City litigator who specializes in plaintiff talc cases, told The Mesothelioma Center at Asbestos.com. “I love the United States of America, but it is a sad day in this country when a megacorporation like Johnson & Johnson can take the liabilities for thousands of cancer and death cases, stick them in a brand new ‘spin-off’ in Texas, and then bankrupt it a few weeks later, simply because the litigation is a nuisance to their hundreds of billions in profits every year.”

Bankruptcy court will now determine the amount to be put into a trust fund so that LTL Management can potentially compensate present and future claimants. In the most recent court filing, J&J said it already had established a $2 billion trust.

There are more than 34,000 pending cases today involving Johnson & Johnson’s talc-based products, including Johnson’s Baby Powder. The first talc case filed against J&J was in 2014.

“We are taking these actions to bring certainty to all parties involved in the cosmetic talc cases,” Michael Ullmann, J&J executive vice president and general counsel said in a statement. “While we continue to stand firmly behind the safety of our cosmetic talc products, we believe resolving this matter as quickly and efficiently as possible is in the best interests of the company and all stakeholders.”

Until now, J&J had continued to litigate many cases in court and defend the safety of its products while citing numerous studies that have shown no evidence of contamination. Other studies have shown traces of asbestos contamination.

Despite defending its products, J&J announced in 2020 that it would stop selling its iconic talc-based baby powder in the U.S. and Canada, citing a decline in customer demand based on safety concerns.

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Bankruptcy Will Likely Reduce Talc Settlements

While J&J has won many court cases, it also has lost several high-profile ones. In August, a California state superior court awarded $26.5 million to a woman who said her mesothelioma cancer was caused by a lifetime use of Johnson’s Baby Powder.

In June, the U.S. Supreme Court rejected a request by J&J to consider overturning an earlier, $2.1 billion judgement in Missouri involving 22 women with ovarian cancer.

According to court papers, settlements and verdicts through the last five years for J&J have reached $3.5 billion. Defense costs have been estimated at $1 billion.

J&J is far from the first company to use this reorganization strategy, which involves a business-friendly law that allows assets to be separated from corporate liabilities.

Lumber giant Georgia-Pacific used its Bestwall subsidiary in 2017 to limits its asbestos liabilities. Trane Technologies and Saint-Gobain are in the midst of similar bankruptcy restructuring efforts.

Johnson & Johnson also is still facing scrutiny from a U.S. House of Representatives oversight committee, which demanded in August any information regarding the company’s future bankruptcy plans.

“This stinks,” attorney Andy Birchfield, an Alabama-based plaintiff who represents talc claimants, said in a statement. “They claim their product is safe and then attempt to hide behind bankruptcy. J&J can run, but it can’t hide.”

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Courts Seeing More Secondary Asbestos Exposure Lawsuits

Secondary exposure to toxic asbestos has declined dramatically in recent decades, but known cases of malignant mesothelioma caused by that type of asbestos exposure have continued to climb.

Increasing awareness of the rare cancer has led to the contrasting trends and an expected rise in personal injury lawsuits involving secondary asbestos exposure.

“One of the reasons is that we are getting better at diagnosing the disease,” attorney Daniel Wasserberg, who specializes in asbestos litigation, told The Mesothelioma Center at asbestos.com. “Years ago, a woman with classic mesothelioma symptoms, but with no obvious exposure, might have had her diagnosis overlooked. Today, with the advances in science and medicine, doctors are more likely to figure out the diagnosis if it is, in fact, mesothelioma.”

Wasserberg, of the New York law firm Meirowitz & Wasserberg, was counsel in a recent case in Richland County, South Carolina, where a jury awarded $32 million in damages to Robert Weist, whose wife Kathy died of mesothelioma caused by the asbestos he inadvertently brought home on his clothes.

Jurors assigned liability to both Kraft Heinz Co., the premises owner, and Metal Masters Inc., the contractor that supplied the asbestos-containing materials used at the processing plant where Weist worked.

Mesothelioma Diagnoses Rise After Latency Period

Secondary exposure is much less common today, but the lengthy latency period between exposure and diagnosis of mesothelioma can be 10 to 50 years, turning past exposure into future health problems.

Kathy Weist was just 62 years old when she died. Her husband, father and uncle all worked at various companies throughout the 1960s, ’70s and ’80s, when asbestos use was prevalent. She never did.

“Younger people are being diagnosed now, and oftentimes the asbestos exposure was through the work of parents, uncles, stepparents or other loved ones bringing home the asbestos on their clothes,” Wasserberg said. “You don’t have to be working in a dusty plant all day to get mesothelioma. You can get it from a much lesser exposure. And we’re typically able to identify the source of the asbestos exposure.”

Industries today, where asbestos products are still used, are more heavily regulated and required to provide the necessary safeguards to prevent take-home exposure, mostly eliminating the threat. Contaminated work clothes must be laundered and equipment must be sanitized. Showers must be taken to prevent asbestos coming home on skin or hair.

It wasn’t that way through much of the 20th century, when men made up the majority of the industrial working class. They returned home carrying asbestos fibers on their clothes, skin and hair, indirectly exposing their families to the toxic substance.

Better Diagnostic Tools Reveal Disease Earlier

Women who often did laundry and children who hugged their fathers or helped their mothers were unknowingly exposed to asbestos. Children from that era, now aging adults, are only now developing asbestos-related diseases that can be more accurately diagnosed through recent medical advances.

Without a known occupational history of exposure, doctors in the past rarely suspected or even looked for mesothelioma, a rare cancer caused almost exclusively by asbestos.

Vague early symptoms of coughing and shortness of breath, tightness of the chest or abdominal pain were attributed to more common health problems.

But imaging scans today, such as MRIs and CT scans, are more precise. Biopsies are taken sooner. There are specific blood tests and even breath tests that can be helpful in diagnosing the disease. Everyone is much more aware.

“It used to be thought these cases of secondhand exposure were weaker for an attorney because it was harder to show where the exposure came from,” Wasserberg said. “But with the right workup, you actually have a better chance of getting a sympathetic jury that really cares.”

Although the number of mesothelioma lawsuits nationally has declined the past two years, the percentage of nonoccupational asbestos-related cases for women has risen significantly, according to KCIC, a national consulting firm that manages litigation.

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EPA Settles Lawsuits, Agrees to Broader Asbestos Risk Evaluations

Facing legal pressure from health and advocacy organizations, the U.S. Environmental Protection Agency has agreed to broaden its ongoing Risk Evaluation for Asbestos under the Toxic Substances Control Act.

An agreement to settle two lawsuits – both alleging inadequate evaluation of toxic asbestos – was filed Oct. 13 in the U.S. Court of Appeals for the Ninth Circuit in San Francisco.

The Asbestos Disease Awareness Organization was the lead plaintiff in the risk evaluation litigation and was joined by health organizations, scientists and doctors, including acclaimed thoracic surgeon Dr. Raja Flores of Mount Sinai Hospital in New York City.

“We are pleased [with the agreement] because a more robust and comprehensive evaluation will better document the immense harm asbestos continues to cause in the United States,” said Linda Reinstein, president and co-founder of ADAO.

Included in the agreement is a consent decree with a commitment from the EPA to finish Part 2 of its risk evaluation by Dec. 1, 2024, and to provide the court with updates on its progress every 180 days. The next draft scope document will be available for public comment by the end of the year.

“EPA will continue to move forward with actions, including the risk evaluation of asbestos, to ensure the public is protected from unreasonable risks in a way that is supported by science and the law,” an EPA spokesperson told The Mesothelioma Center at Asbestos.com.

Legacy Asbestos Hazards Remain

Exposure to asbestos, a naturally occurring mineral once used ubiquitously in manufacturing, can cause serious health issues, including mesothelioma, an aggressive cancer with no definitive cure. The most glaring problem today is legacy asbestos, most of which is found in older, deteriorating construction throughout the country.

The use of asbestos products has declined dramatically in recent decades and is heavily regulated. There is no mining of the product within the U.S. The only raw asbestos being imported today is used by the chloralkali industry to manufacture chlorine.

Part 1 of the EPA’s risk evaluation task was completed in December 2020. It was roundly criticized by health organizations, particularly because it included only chrysotile asbestos, the only form of asbestos to be imported, processed or distributed within the U.S.

Its decision to wait for Part 2 in addressing legacy asbestos also was criticized, along with the absence of a clear scope of what it would include and when it would be finished.

Talc Products To Be Addressed by EPA

As part of the broadened scope of the EPA’s Part 2 risk evaluation, the recent agreement included an evaluation of:

  • Talc and talc-containing products potentially contaminated with asbestos fibers and the human health hazards they present
  • Health hazards of five more types of asbestos fibers: crocidolite, amosite, tremolite, anthophyllite and actinolite
  • Evidence involving noncancer health hazards of asbestos – including asbestosis – in addition to all cancer health hazards
  • Risks to human health from all environmental pathways of exposure to asbestos, including ingestion, inhalation and dermal contact
  • Health risks of potentially exposed individuals who may be more susceptible to the dangers of asbestos

Also included in the agreement was the EPA’s emphasis on addressing all legacy uses and associated disposal of six fiber types of asbestos.

“After years of delay, we will finally have an enforceable court order that assures that EPA performs its legal duty to determine the risks of legacy asbestos,” said Bob Sussman, ADAO’s attorney. “This is encouraging progress.”

ADAO Continues to Advocate for an Asbestos Ban

The EPA has emphasized that the risk evaluation, which began in 2016, never was intended to address legacy asbestos. It was only added in 2019.

Its Part 1 evaluation found 16 conditions of asbestos use that presented unreasonable risks to human health, either through occupational exposures or consumer uses.

ADAO, the leading nonprofit aimed at eliminating asbestos exposure of all types, has been lobbying Congress for many years to impose a complete ban on asbestos. Several efforts throughout the years have failed.

The closest came a year ago when the Alan Reinstein Ban Asbestos Now Act of 2020 appeared to have broad support but failed to advance through the U.S. House of Representatives. More than 60 countries already have banned asbestos.

Only in recent years has ADAO turned toward legal issues, mostly directed at the EPA. Judge Phyllis J. Hamilton is overseeing the recent ruling.

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Researchers Open Phase I Clinical Trial of Cryoablation with Keytruda

Memorial Sloan Kettering Cancer Center in New York City has opened a novel clinical trial that combines the immunotherapy drug Keytruda with cryoablation for patients with unresectable malignant mesothelioma.

The phase I trial opened in September and will be available at seven Memorial Sloan Kettering locations in the New York City/New Jersey area.

Cryoablation, which is also known as cryotherapy or cryosurgery, is a treatment that freezes localized tumors with argon gas or liquid nitrogen. It has been used effectively with liver, kidney and prostate cancers, but its use with mesothelioma has been limited because of the cancer’s diffuse tumor makeup.

Although cryoablation can kill tumor cells with extreme cold, the aim of this latest study is to evaluate its safety and synergy with Keytruda in activating a patient’s own immune system to fight the cancer.

Keytruda, known generically as pembrolizumab, was approved by the U.S. Food and Drug Administration in 2020 for treatment of certain adult and pediatric cancers, but only for those with high mutational burden and no alternative treatment options.

Trial Targets Patients with Unresectable Mesothelioma

The single-arm, single-institution study is currently recruiting and is expected to be completed by the end of 2023. It is open to pleural mesothelioma and peritoneal mesothelioma patients whose tumors cannot be removed with surgery.

Treatment involves one cycle of Keytruda given intravenously, followed by the cyroablation targeting a designated lesion. Keytruda cycles will be continued for up to 24 months. To participate, patients must have had at least one prior line of systemic therapy.

Keytruda has been especially effective with a small percentage of mesothelioma patients who have tried it under special access programs or in other clinical trials. The rate of success has been varied when combined with other treatments.

Dr. Michael Offin, an oncologist at Memorial Sloan Kettering and the trial’s principal investigator, declined to provide additional insight on the study to The Mesothelioma Center at Asbestos.com.

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Cryoablation Has Had Success Slowing Recurrence

Although most cancer hospitals have opted against using cryoablation with mesothelioma, the UCLA Jonsson Comprehensive Cancer Center, which is aligned with the innovative Pacific Mesothelioma Center, found it to be a valuable tool as a follow-up procedure to slow the inevitable recurrence of this aggressive cancer with no definitive cure.

UCLA interventional radiologist Dr. Fereidoun Abtin detailed his cryoablation results after using the procedure 110 times with mesothelioma patients.

In his study, Abtin emphasized the procedure was intended only to delay local recurrence after standard treatment, which involved surgery, chemotherapy and radiation.

“The results have been impressive, a lot better than what else is out there,” he told Asbestos.com in 2016. “It’s something we want people to know about.”

All patients experienced at least 30 days without recurrence after treatment. More than 90% of them went at least six months without recurrence.

Memorial Sloan Kettering Taking the Lead

Memorial Sloan Kettering has several clinical trials involving mesothelioma that are drawing considerable attention beyond the latest with cryoablation. Among those are:

  • A phase I clinical trial using a patient’s genetically engineered T cells to kill the tumor by counteracting the protein mesothelin that often stops a patient’s own immune system from working properly.
  • A phase I clinical trial to study the safety and efficacy of the cancer vaccine galinpepimut-S when used in combination with the immunotherapy drug nivolumab (Opdivo) for patients with relapsed disease.
  • A phase I clinical trial studying the effectiveness of using nivolumab in combination with standard chemotherapy prior to aggressive surgery for patients with pleural mesothelioma.

UCLA Medical Center announced a pilot study in 2020 in line with this latest clinical trial in New York. It intended to measure immune system stimulation when cryoablation was used prior to surgery.

The study, however, was postponed indefinitely, leaving Memorial Sloan Kettering to reopen its mesothelioma cryoablation trial.

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New Opdivo/Yervoy Mesothelioma Clinical Trial Begins Soon

A novel clinical trial involving the immunotherapy combination of Opdivo and Yervoy will open soon in Chicago. The goal is to study the drugs’ efficacy when added to surgery for patients with peritoneal mesothelioma cancer.

The single-center, phase II clinical trial follows a recent report detailing the impressive three-year effectiveness of the drug combination when used for unresectable pleural mesothelioma.

Bristol Myers Squibb manufactures Opdivo and Yervoy, known generically as nivolumab and ipilimumab. The U.S. Food and Drug Administration approved the combination for pleural mesothelioma in 2020, making it the first new systemic mesothelioma treatment in 15 years. Health organizations around the world, including those in Japan, China and the European Union, have issued similar first-line treatment approval.

This latest clinical trial is expected to include close to 40 patients and last at least three years. It was approved in September and is scheduled to begin Jan. 1, at the University of Chicago Medicine Comprehensive Cancer Center. Participation, including pre-surgery treatment, post-surgery treatment and observation, will last at least 18 months.

Researchers Expand Use of Immunotherapy

An estimated 1,000 people are diagnosed annually in the U.S. with peritoneal mesothelioma, which develops in the thin layer of tissue lining the abdomen and often spreads throughout the abdominal cavity. Pleural mesothelioma grows in the tissue lining the lungs and chest cavity.

Although the pleural and peritoneal types of mesothelioma are molecularly and immunologically distinct, the Opdivo/Yervoy combination’s growing success with other cancers has led researchers to continue expanding its reach.

Opdivo and Yervoy both are known as checkpoint inhibitor drugs, but they work in different ways. When used with mesothelioma they have shown an effective synergistic response with T cells, a type of white blood cell that is part of the immune system. Opdivo helps the T cells discover the tumor, while Yervoy proliferates and activates the T cells to kill the tumor cells.

Peritoneal mesothelioma is being treated most effectively today with a combination of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy, also known as HIPEC. The hope is that adding the immunotherapy will make it even better.

Although the Opdivo/Yervoy combination is not FDA-approved for peritoneal mesothelioma, the University of Texas MD Anderson Cancer Center in Houston has reported some success recently with off-label usage of the treatment for patients with inoperable disease.

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Study to Focus on Effectiveness with Surgery

The goal of the Opdivo/Yervoy clinical trial is to determine whether administering the immunotherapy combination before surgery decreases the tumor burden, and if it delays any cancer regrowth if given after surgery. It will be the first time Opdivo and Yervoy have been used together with patients also receiving surgery and HIPEC.

Trial principal investigator and surgical oncologist Dr. Kiran Turaga did not respond to requests from The Mesothelioma Center for additional insight.

Three-year data from the latest clinical trial, named CheckMate 743, was presented at the European Society for Medical Oncology conference last month. It involved patients with inoperable pleural mesothelioma and compared those receiving the immunotherapy combination with those receiving standard chemotherapy.

CheckMate 743 Clinical Trial Results
Opdivo/Yervoy Chemotherapy
Three-year Survival Rate 23% 15%
Three-year Durable Response Rate 28% 0%
Median Duration of Response 11.6 months 6.7 months
Median Overall Survival 18.1 months 14.1 months

“Results from the CheckMate 743 trial have changed the way physicians treat pleural mesothelioma,” said Dr. Abderrahim Oukessou, thoracic cancers development lead for Bristol Myers Squibb. “We continue to see more evidence for the sustained survival benefits of dual immunotherapy across several tumors.”

The company said the Opdivo/Yervoy combination has also shown significant survival improvement in phase III clinical trials involving metastatic melanoma, non-small cell lung cancer, esophageal squamous cell carcinoma and advanced renal cell carcinoma.

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Virtual Symposium to Focus on Mesothelioma Treatment Advances

Sylvester Comprehensive Cancer Center of South Florida will host its free virtual First Miami International Mesothelioma Symposium on November 6, 2021.

The Mesothelioma Program at the Sylvester Comprehensive Cancer Center has grown to become one of America’s leaders in this specialized field, attracting a wide range of expertise for its upcoming virtual symposium.

Mesothelioma is such a rare disease that we really have to bring in experts from around the world to get a true picture of what’s coming next. And I think we’ve done that with our program,” medical oncologist Dr. Estelamari Rodriguez, Symposium co-chair, told The Mesothelioma Center at Asbestos.com. “Our goal is to raise the level of care for all patients.”

Global Presenters

Co-chairs of the event, all from the University of Miami, are thoracic surgeon and mesothelioma specialist Dr. Nestor Villamizar; medical oncologist Dr. Gilberto Lopes, associate director for Global Oncology; and Dr. Rodriguez, co-lead of the Thoracic Site Disease Group.

Along with the multidisciplinary staff at the University of Miami’s Sylvester Comprehensive Cancer Center, featured speakers and panelists will include some world-renowned mesothelioma experts.

Among them:

Thoracic surgeon Dr. Raphael Bueno, who followed legendary Dr. David Sugarbaker as executive director of the Mesothelioma Program at Brigham & Women’s Hospital and Dana Farber Cancer Institute in Boston.

Dr. Dean Fennell, mesothelioma specialist and chairman of Thoracic Medical Oncology at University of Leicester and University Hospitals of Leicester, United Kingdom.

Dr. Anna Nowak, vice chancellor, Health and Medical Research, at University of Western Australia, Perth.

Dr. Aaron Mansfield, thoracic medical oncologist at Mayo Clinic in Rochester, Minnesota, who played a significant role in the clinical trials that led to the latest Food and Drug Administration immunotherapy treatment approval for unresectable pleural mesothelioma.

“There is a lot of movement with this disease today, a lot of changes,” Dr. Rodriguez said. “We want to bring everyone up to speed, what the standards are today, and what’s on the horizon for tomorrow.”

Doctors and Patients Attending

One aim of the Symposium is to not only spotlight the most promising emerging treatments, but to share vital information with medical professionals who rarely see this type of cancer. Inexperience with mesothelioma and unfamiliarity with the latest treatment developments can lead to delays in receiving the best treatment options and even initial misdiagnosis.

From the staff at the Sylvester Cancer Institute:

Dr. Diana Molinares will speak about mesothelioma symptom management and survivorship.

Surgical oncologist Dr. Mecker Moller will address the latest surgical approach, which includes HIPEC (hyperthermic intraperitoneal chemotherapy), in treating peritoneal mesothelioma.

Dr. Rodriguez will report on the growing role of neoadjuvant treatments that have allowed more patients to undergo potentially-curative surgery.Radiation oncologist Dr. Alan Dal Pra will present the latest developments in radiation treatment for pleural mesothelioma.

Immunotherapy Will Be Featured

Dr. Fennell will speak on the personalization of mesothelioma treatment in the United Kingdom. Dr. Mansfield will focus on the genomics and epigenetics of treatment.

Thoracic oncologist Dr. Azam Ghafoor, from the National Cancer Institute, will focus primarily on the growing status of immunotherapy and moving away from past reliance on chemotherapy.

Dr. Gilberto de Lima Lopes from the Sylvester Cancer Center will open the program, speaking on the global burden of Mesothelioma.

“We’re proud of the multidisciplinary approach that has worked well for us [at Sylvester Comprehensive Cancer Center]. We’re equipped here to handle the complexity of care required to help patients from diagnosis through treatment and survival,” Dr. Rodriguez said. “We want to share that knowledge to help others everywhere.”

The virtual Symposium is free and requires only online registration.

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