Mesothelioma Antiestrogens and Medical Management
Mesothelioma Antiestrogens and Medical Management
Another study is called, "The palliative benefits of MVP (mitomycin C, vinblastine and cisplatin) chemotherapy in patients with malignant Mesothelioma" by E. Andreopoulou, P. J. Ross, M. E. R. O'Brien*, H. E. R. Ford, K. Priest, T. Eisen, A. Norton, S. Ashley and I. E. Smith - Oxford Journals Medicine Annals of OncologyVolume15, Issue9Pp. 1406-1412. Here is an excerpt: "Abstract - Background: With the rising incidence of malignant mesothelioma (MM), it is important to optimise treatment to control symptoms, maintain quality of life and, if possible, prolong life. We have analysed prospectively collected data to evaluate a frequently used palliative chemotherapy regimen. Patients and methods: Between October 1986 and May 2002 all patients with inoperable pleural mesothelioma were considered for treatment with MVP (mitomycin C 8mg/m2 every 6 weeks, vinblastine 6mg/m2 every 3 weeks and cisplatin 50mg/m2 every 3 weeks) chemotherapy. Symptoms were assessed by physician assessment at baseline and after each cycle of chemotherapy.
Results: One hundred and fifty patients were treated with MVP for mesothelioma. Forty-three per cent had a performance status (PS) 2 or worse. The response rate was 15.3%, with 68.6% having stable disease. Sixty-nine per cent reported an improvement in symptoms; in particular there were good responses for pain (71%), cough (62%) and dyspnoea (50%). The most common grade 3/4 toxicity was neutropenia (22%). Median overall survival was 7 months, with 1-year survival 31% and 2-year survival 11%. Median survival for patients with PS 0/1 was 10 months, and was 6 months for patients with PS 2/3. Poor prognostic factors in univariate analysis included poor PS, weight loss, mixed or sarcomatoid histology, low haemoglobin and high white blood cell count. Excluding pathological subtype, the prognostic significance of poor PS and weight loss were retained in multivariate analysis. Conclusions: Palliation of symptoms in MM is achievable with current cisplatin-based treatments.
A third study is called, "Preoperative Evaluation of Patients With Malignant Pleural Mesothelioma: Role of Integrated CT-PET Imaging" by Truong, Mylene T. MD; Marom, Edith M. MD; Erasmus, Jeremy J. MD - Journal of Thoracic Imaging: May 2006 - Volume 21 - Issue 2 - pp 146-153 Symposia. Here is an excerpt: "Abstract - Malignant pleural mesothelioma (MPM) is an uncommon neoplasm arising from mesothelial cells of the pleura. The prognosis is poor with a median survival of 8 to 18 months after diagnosis. Multimodality regimens combining chemotherapy, radiotherapy, immunotherapy, and surgery are being used more frequently in patient management. Extrapleural pneumonectomy is the surgical treatment of choice in 10% to 15% of patients who present with resectable disease and is reported to prolong survival. Accurate staging is important to distinguish patients who are resectable from those requiring palliative therapy. Integrated computed tomography-positron emission tomography (CT-PET) increases the accuracy of overall staging in patients with MPM and significantly improves the selection of patients for curative surgical resection. Specifically, CT-PET detects more extensive disease involvement than that shown by other imaging modalities and is particularly useful in identifying occult distant metastases. This article reviews aspects of imaging performed in the initial staging of patients with MPM according to the International Mesothelioma Interest Group staging system and will emphasize the appropriate role of CT-PET imaging in determining the T, N, and M descriptors."
Another study is called, "Expression profile of telomerase subunits in human pleural Mesothelioma" by Karl Dhaene, Jan Wauters, Barbara Weyn, Jean-Pierre Timmermans, Eric van Marck, - The Journal of Pathology Volume 190, Issue 1, pages 8085, January 2000. Here is an excerpt: "Abstract - Using the TRAP assay, telomerase activity was previously detected in over 90% of human pleural mesotheliomas (MMs), but not in mesothelial cell cultures (MCCs), suggesting that telomerase re-activation occurs during multi-step mesothelioma carcinogenesis. The present study determined the expression of the telomerase RNA template (hTERC), the telomerase-associated protein (hTEP1), and the telomerase catalytic sub-unit (hTERT), in 16 pleural MMs and 4 MM-derived cell lines, in two pleural solitary fibrous tumours and in six MCCs. Reverse transcription-polymerase chain reaction analysis revealed that hTERT mRNA expression parallels the activity status documented by the TRAP assay, whereas hTERC and hTEP1 mRNA are commonly expressed in all malignant and non-malignant serosal cells and tissues. Three alternatively spliced hTERT transcripts were detected in all telomerase-positive samples, whereas neither variant could be detected in the MCCs. Detection of the hTERT protein with a commercially available antibody was not successful. These results indicate that hTERT expression is rate-limiting for human telomerase activity and that re-activation, rather than up-regulation, of hTERT expression can play a critical role in MM carcinogenesis. While waiting suitable anti-hTERT antibodies, these results provide information for the design of hTERT mRNA-specific in situ probes to study telomerase in archived pre-malignant serosal lesions."
We all owe a debt of gratitude to these fine researchers. If you found any of these excerpts interesting, please read the studies in their entirety.
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