Handling Challenges on Your Mesothelioma Journey

Posted on March 17, 2017 by Ellie

When challenges happen in life it can change our life’s plan. How we handle those challenges often can define your life for better or worse. “Challenges are what make life interesting and overcoming then is what makes life meaningful,” Joshua J. Marine.

For patients diagnosed with mesothelioma the way they handle the diagnosis and the reality that the remainder of their time on earth can be limited, can be a challenge. Like all of us, we know on an intellectual level that we are all going to die, but to face death and dying and make choices on the way we want to live out our final days, can require support and courage. Sometimes, and hopefully all the time, support can be found with family, friends, community and your medical team.

Medicine has recognized that there is a need for specialists to look at the big picture in a patient’s treatment. What is important to the patient? How are the symptoms of their disease affecting the way they live? Palliative care specialists are focused on what is important to the patient, not just in the context of their disease but in the context of their lives.

In the January 3rd, 2017 edition of the New York Times there is an article by Jon Moolallem about B.J. Miller a doctor who also is a triple amputee. The article is about Dr. Miller who is a pain and palliative care specialist, in a part of the article he tells the story of the tragic death of a young mesothelioma patient at the Zen Hospice in San Francisco. The back story of Dr. Miller’s life is woven into the story of how he became a physician, how he handled his accident in college, and his philosophy on living and on how we die. Palliative care focus is on relieving symptoms so that you can lead the best possible life. The article is well-written and worth reading.

The story of the death of Randy Sloan from mesothelioma at the age of 27 at the Zen Hospice is inspiring. By chance Dr. Miller and Randy knew each other as Randy had worked at a motorcycle shop and had worked on specializing a motorcycle for Dr. Miller a year before he was diagnosed with mesothelioma. Randy’s journey with mesothelioma was quick and devastating. He had an aggressive course that robbed him of his life very quickly. Through the Zen Hospice, Dr. Miller, his family, Randy’s death was on his terms. One of the things that Randy wanted to experience was having an ordinary day. A day he did not have to think about chemo, sickness, he was sick of being sick. Dr. Miller explained that the hospice house he ran was the best chance of living out his life the way he wanted to. Although the patient Randy was uneasy he did move in 5 days after his conversation with Dr. MIller. As he got comfortable his friends could be his friends, his mom could be his mom and he could live the way he wanted to.

How one person faced a challenge- his accident and amputations, became a doctor and continues to help other people face their challenges is inspiring. By allowing someone to face death the way they want, on their terms, he has made a difference.

However long a patient’s journey is with mesothelioma or any other disease, palliative care specialists remind all that it is the patient’s choice what treatment he undergoes and when he has had enough.

– Ellie

Ban Asbestos to Prevent Mesothelioma

Posted on March 7, 2017 by Lisa

The way to prevent mesothelioma is by banning asbestos. Research is vital in making progress for a cure. Banning asbestos in the United States will prevent future generations from acquiring these asbestos related diseases.

The Center for Disease Control- CDC- is charged with protection of public health and safety through the control and prevention of disease. As noted on the CDC website www.cdc.gov asbestos victims are still threatened by mesothelioma and other issues caused by asbestos exposure. According to data, an estimated 1.3 million construction and general manufacturing workers are potentially being exposed to asbestos. Approximately 1,700 metric tons a year of asbestos is still used in the U.S. in a wide variety of construction and manufacturing applications.

OSHA has tried to enforce limits of what is legal in the work place. OSHA has also taken the position that no level of exposure is safe. In 1989, the Environmental Protection Agency attempted to ban asbestos but were unsuccessful because of court challenges.

Each time we have the privilege of meeting new mesothelioma patients it reminds us that mesothelioma is not going away. We have seen patients as young as 18 and as old as 90. These patients are not statistics — they are all unique individuals with their own story to tell. For most the asbestos exposure happened years ago. The period from exposure to symptoms can be 20 to 40 years.

How do we raise awareness about the use and banning of asbestos in the United States? There is one organization that is dedicated to banning asbestos, Asbestos Disease and Awareness Organization- ADAO. Linda Reinstein and Alan Larkin founded this organization in 2004 after the death of Linda’s husband, around the same time a close relative of Alan’s also died from mesothelioma. For the 13^th year ADAO is hosting a conference in Washington D.C. from April 7^th to 9^th at the Renaissance Arlington Capital View Hotel.

Getting involved in prevention and research for a cure is a positive way to honor all those effected by mesothelioma. Raising awareness amongst others and our government leaders that asbestos needs to be banned, educating all of us to the dangers of asbestos, can serve to honor all that have died and all that are suffering with asbestos related diseases.

– Lisa

Mesothelioma Patient Care: Behind The Scenes

Posted on March 3, 2017 by Ellie

Every successful team needs people that work behind the scenes. In sports, it could be the trainer or the statistician, the person who does the scheduling, or the people in charge of the uniforms. Whatever the job it is necessary to keep the organization moving forward and progressing.

In the mesothelioma community, there are many people behind the scenes. Many people are trying to make a difference for the patients, families, caregivers and friends that have been affected by mesothelioma. Often the importance of their work is not recognized.

Recently when talking to a patient advocate we were reminded about how difficult it is to navigate the health care system on a regular basis and how difficult it can be when you are dealing with mesothelioma. A question about insurance coverage came up for one of the patients. They could not afford one of their prescriptions. The prescription was necessary for their recovery. After multiple phone calls and some arm twisting she developed a plan and could get the medication that the patient needed.

A researcher that we regularly see always asks about the patients. He asks because we can help him put a face to the stories about the patients. He usually does not meet the patients, his passion is research, but the stories are inspirational to him to know. He can make the connection that the work he is doing is making a difference.

A radiologist does his job during the day and during the evenings works on a clinical trial for mesothelioma. The disease is a personal interest of his. He knows that today’s research that is being conducted is hope for tomorrow’s cure.

The intake coordinator at the hospital is often the point of first contact for patients and families. A patient this week told me a story of how he was diagnosed with a life-threatening cancer and told that without treatment he had 3-6 months to live. The first appointment he could get with his local oncologist was 3 weeks from the day he was told his devastating diagnosis. Three weeks to someone who was just told he has 3-6 months and was in considerable pain is a lifetime. He made a few calls, he could navigate the system, and was seen the next day by an oncologist and a pain MD. Once in the MD’s office he was admitted to the hospital for workup and pain control. He now has a plan.

There are countless stories of people behind the scenes working tirelessly to make the patient and families experience better.

For mesothelioma patients and families please reach out there is a community surrounding you and many more behind the scenes that want to help.

– Ellie

MESOTHELIOMA CLINICAL TRIAL REVIEW- GENETICALLY MODIFIED T CELLS IN TREATING PATIENTS WITH STAGE III-IV NON- SMALL CELL LUNG CANCER OR MESOTHELIOMA

Posted on February 17, 2017 by Ellie and Lisa

We encourage participation in clinical trials for research leading to a cure for mesothelioma. It is known that nationally the statistics for participation in adult cancer trials is between 3-5% of adults who have a cancer diagnosis.

For mesothelioma patients and families that are interested in clinical trials, researching clinical trials and eligibility can be a time-consuming barrier to participation. The information about clinical trials is available on www.clinicaltrials.gov

Our goal is to feature one mesothelioma clinical trial monthly and break it down to understandable terms, to decipher the eligibility requirements, and to possibly encourage participation in these trials.

Listing- ClinicalTrials.gov- NCT02408016

Official Title- Phase I/II Study in WT1-Expressing Non- Small Cell Lung Cancer and Mesothelioma, Comparing Cellular Adoptive Immunotherapy With Polyclonal Autologous Central Memory to Naïve CD8+ T Cells That Have Been Transduced to Express a WT1- Specific T-Cell Receptor

Sponsor- Fred Hutchinson Cancer Research Center

Location- Fred Hutch/University of Washington Cancer Consortium Seattle Washington 98109

Principal Investigator-Sylvia M. Lee- 206 288 2274 smlee@fredhutch.org

Contact- Sylvia M. Lee 206 288 2274 smlee@fredhutch.org

Purpose- This phase 1/11 trial studies the side effects and best dose of genetically modified T cells in treating patients with stage 111-IV non-small cell lung cancer (NSCLC) or mesothelioma. Many types of cancer cells, including NSCLC and mesothelioma, but not most normal cells, have a protein called Wilms tumor (WT)1 on their surfaces. This study takes a type of immune cell from patients, called T cells, and modifies their genes in the laboratory so that they are programmed to find cells with WT1 and kill them. The T cells are then given back to the patient. Cyclophosphamide and aldesleukin may also stimulate the immune system to attack cancer cells. Giving cyclophosphamide and aldesleukin with laboratory – treated T cells may help the body build an immune response to kill tumor cells.

Screening– Documentation of NSCLC or mesothelioma by histopathological sample

Patient must be able to give informed consent
Patient must be able to provide blood and tumor samples and undergo the procedures
Required for this protocol

Eligibility Criteria—Inclusion therapy- Three arms of study- For Arm 1

Patient must express human leukocyte antigen (HLA)- A*0201
Evidence of WT1 tumor expression
Patients must have received at least one line of therapy for NSCLC or mesothelioma or previously documented to have declined therapy

NSCLC patients with a mutation in epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK) must have demonstrated progression or intolerance to at least one of the corresponding targeted therapies (for example erlotinib or crizotinib)

Bi-dimensionally measurable disease by palpation, clinical exam, or radiological imaging (X-ray, computed tomography (CT) scan, positron emission tomography (PET) scan, magnetic resonance imaging (MRI) or ultrasound)

Ninety days must have passed since the last doses of radiation or chemoradiation treatment involving lung tissue or thorax prior to T cell infusion

Patients treated with prior immunotherapy including and not limited to vaccines, cytokines. T cell stimulating agents, cytokines, T cell stimulating agents, cytoxic T lymphocyte antigen 4 (CTLA4) inhibitors and programmed death (PD)-1 check point inhibitors are allowed on therapy provided they did not have any severe grade 4 toxicities due to prior therapy and any toxicities due to prior therapy should have resolved. If resolvable to less than or equal to grade one

ELIGIBILITY FOR TREATMENT ON ARM 2

Patients must express HLA-A*0201
Evidence of WT 1 tumor expression
Ninety days must have passed since the last definitive doses of radiation or chemoradiation treatment prior to T cell infusion

Exclusion Criteria– EXCLUSION FOR ENROLLMENT / SCREENING (ARMS 1 AND 2)

. Performance status by Eastern Cooperative Oncology Group (ECOG) performance status >=2
Active autoimmune disease in which possible progression during treatment would be considered unacceptable by the investigators
Any condition or organ toxicity deemed by the (PI) or the attending physician to place the patient at unacceptable risk for the treatment of the protocol
Men or women of reproductive ability who are willing to use effective contraception or abstinence; women of childbearing potential must have a negative urine test within two weeks prior to first infusion.
Pregnant women and nursing mothers will be eligible for screening only to test HLA type by saliva or buccal swab and WT1 expression from previously collected tissue sample
Clinically significant and ongoing immune suppression including, but not limited to, systemic immunosuppressive agents such as cyclosporine or corticosteroids

EXCLUSION FOR TREATMENT (ARMS 1 and 2)

Exclusions for the leukapheresis procedure (can be performed later as symptoms resolve)
Infection with or without antibiotic treatment
Recent hepatitis exposure
Pregnancy or nursing
HIV or human T-lymphotropic virus (HTLV) infection
Positive result on standard test for Syphilis
Unable to generate antigen-specific WT1-specific CD8+T cells for infusions; however, the patient will have the option to receive WT1-specific T- cells if a lower than planned number of cells is available
Documented infections or known oral temperatures >38.2 degrees Celsius © fewer than 72 hours prior to receiving study treatment or systemic infection requiring chronic maintenance; the start of treatment may be delayed
Systemic steroids should be stopped 2 weeks before the start of treatment; topical and inhaled steroids are allowed
Untreated central nervous system (CNS) metastasis that are > 1cm or symptomatic are not allowed; (patients with CNS metastases >1 cm or symptomatic that have been treated and demonstrated to be radiologically and clinically stable for at least 4 weeks are allowed
WBC- White blood cells < 2,000/ul
Hemoglobin (Hb) <8 g/dl
ANC- Absolute neutrophil count < 1000/ul
Platelets < 50,000/ul
Creatinine >1.5x the upper limit of normal
Aspartate aminotransferase/ alanine aminotransferase (AST/ALT) > 5x upper limits of normal (ULN)
Bilirubin >3 x ULN that cannot be attributed to NSCLC metastasis
HIV or HTLV infection
New York Heart Association functional class lll-lV heart failure, symptomatic pericardial effusion, stable or unstable angina, symptoms of coronary artery disease (CAD), congestive heart failure, clinically significant hypotension or history of an ejection fraction of =<30%

Clinically significant pulmonary dysfunction, as determined by medical history and physical exam, patients identified will undergo pulmonary functions testing and those with forced expiratory volume in the 1 second (FEV1) < 2.0 L or diffusion capacity of the lungs for carbon monoxide (DLCO) (corrected for Hb) < 50% will be excluded

How the Research Study is Designed to Work- Patients are assigned to 1 of 3 treatment arms. This is a phase 1, dose escalation study of autologous WT1-TCRc4 gene-transduced CD8-positive Tcm/Tn lymphocytes followed by a phase 11 study. Once the cells have been reconstucted the cells are given back to the patient with intent that cells will attack to tumor cells.

Sources: www.ClinicalTrials.gov

With any clinical trial, all participation is voluntary. Before enrollment a detailed consent form will be reviewed with the participant and signed. The participant can withdraw from a clinical trial at any point in time. Think about participating if able, the only way to progress to a cure for mesothelioma is through clinical trials.

Please do not hesitate to contact us with any questions.

MESOTHELIOMA SPECIALIST SPOTLIGHT: DR. FARHOOD FARJAH

Posted on February 17, 2017 by Ellie and Lisa

Dr. Farhood Farjah is a thoracic surgeon and researcher. He holds an appointment as an Assistant Professor of Surgery at the University of Washington. Dr. Farhood Farjah obtained his medical degree at Oregon Health and Science University and trained at the University of Washington in general surgery. He did his residency at University at Washington Medical Center and his fellowship at Memorial Sloan-Kettering Cancer Center in New York in cardiothoracic surgery. Dr. Farjah’s postdoctoral research fellowship was funded by the National Institute of Health and National Cancer Institute. Dr. Farjah also has a master’s degree in epidemiology and is the Associate Medical Director of the Surgical Outcomes Research Center. (SORCE).

As a young man, he had always been interested in helping and working directly with people, service and science. Dr Farjah is committed to understanding patients’ goals and helping them achieve them. He plans to use his training, experience and network of colleagues to help patients achieve their goals.

He is involved with research that studies how doctors deliver care to lung cancer and mesothelioma patients in the United States. His goal is that all patients have the best possible outcome. Another of his goals during his research is to increase the quality and value of thoracic oncology patients experiences.

Dr. Farjah has a special interest in occupational related illnesses, including mesothelioma and lung cancer. In addition to treating mesothelioma and lung cancer patients, Dr. Farjah has lectured on the treatment of mesothelioma, including a recent continuing medical education course on “Multi-Modality Treatment of Pleural Mesothelioma.” Dr. Farjah has also taught at the American College of Surgeons. The mesothelioma community is fortunate to have Dr. Farjah to help in the fight against mesothelioma and to help patients, especially those in the Pacific Northwest.

MESOTHELIOMA CENTER REVIEW – UNIVERSITY OF WASHINGTON

Posted on February 17, 2017 by Ellie and Lisa

We recommend that when you or your family member is diagnosed with mesothelioma that you be evaluated at an academic, multidisciplinary, mesothelioma center. In order to help you become familiar with what a center can offer, we feature one center per month.

University of Washington Medical Center

1959 NE Pacific Street

Seattle Washington 98195

Phone: 206-598-3300

Mission – “To improve the health of the public.”

University of Washington has been recognized as one of the top five cancer centers in the United States. University of Washington Medical Center, in collaboration with the Seattle Cancer Care Alliance and Fred Hutchinson Cancer Research Center, is the only National Comprehensive Cancer Network in the Pacific Northwest.

History – The University of Washington Medical Center was founded on May 4, 1959. The University of Washington lung cancer team is composed of leading healthcare professionals with extensive clinical expertise. The team offers a multidisciplinary approach to your individual cancer. Based on the type and location of your cancer, the genetics, life circumstances, and other unique factors, the treatment plan is developed.

Depending on your diagnosis, you will receive care at University of Washington Medical Center, Northwest Hospital & Medical Center or the Seattle Cancer Care Alliance. The Seattle Cancer Care Alliance is a cooperative alliance of UW Medicine, Fred Hutchinson Cancer Research Center and Seattle Children’s Hospital.

Diagnosis of lung cancer and mesothelioma are seen at the Seattle Cancer Care Alliance, 825 Eastlake Ave. E PO Box 19023 Seattle, WA 98109-1023- Patient intake office 206 288 7222

Director – Seattle Cancer Care Alliance

Dr. Michael S. Mulligan MD- Director of Advanced Lung Disease Surgery Program He performs a range of lung cancer resections..

Team – Keith D. Eaton PHD Medical Oncologist Dr. Bernardo H.L. Goulart, MD MS Medical Oncologist Renato G. Martins, MD MPH medical director for thoracic/head and neck oncology.

Dr. Marcus Neubauer MD medical oncology , Dr. Patel is a radiation oncologist who specializes in the treatment of thoracic cancer including lung, thymic and tracheal tumorsDr. Christin Rodriguez Md medical oncologist

Dr Farhood Farjah M.D. – thoracic surgeon at University of Washington- trained at Memorial Sloan –Kettering Cancer Center in cardiothoracic surgery

Affiliations Thoracic Surgery Clinic at University of Washington Medical Center and Seattle Cancer Care Alliance at South Lake Union

Stats – University of Washington Medicine is one of the top academic research institutes in National Institute of Health funding.

UW is recognized as a national leader in biomedical research

Resources – The Seattle Cancer Care Alliance Hospitality House offers a variety of apartment style units within blocks of the SCCA outpatient clinic. Reservations: 206-204-3700 or email sccahouse@seattlecca.org

The Seattle Cancer Alliance Hospitality House offers a shuttle bus to local grocery store twice a day. The shuttle also offer rides to and from hospital

Seattle Cancer Care Alliance have computer workstations, internet connections, fax machines, copier and printer, free notary and wig fitting

They also offer a lending library which may help with ones cancer journey.

Seattle Cancer Center also offers support for children, teens and caregivers.

Contact – Schedule an appointment 1-855-557-0555

People diagnosed with Mesothelioma are seen in the general oncology clinic on 4^th floor at Seattle Cancer Care Alliance Clinic Building. Treatments for this disease may occur in this building. Surgical procedures however take place at University of Washington Medical Center where follow up appointments maybe necessary.

The Importance of Communication in Your Mesothelioma Journey

Posted on February 6, 2017 by Lisa

Communication is essential in life and even more so when dealing with a new diagnosis of mesothelioma. Dealing with the news on an emotional level and on an intellectual level can be overwhelming. Trying to educate yourself about this rare, very complex cancer is best done with support from family and medical experts.

A recent study found that 60% of people did not understand the instructions that they received from their doctor appointments. Often what is said and what is heard are very different. How do you make sure that you and your medical team are on the same page? One way is to bring someone with you that can also hear what is being said. When you are under stress and emotionally overwhelmed you are more likely to misread people. If possible you need to stay in the moment. The emotions of anger, fear and anxiety are all very normal responses. As you gather all the information that you need about your treatment, try to channel your emotions in a positive direction.

One of the difficulties of dealing with a new diagnosis of mesothelioma is there are no black and white answers. Questions are asked and sometimes it seems that there are no satisfactory answers. We are used to having some control in our lives, and suddenly you are on a path that has few signs on it.
What are you willing to do to fight this disease? This is a question that only you can answer after talking to your mesothelioma doctor. Do their recommendations work for you? Is the treatment plan one which you understand?

This past week, we observed two patients in two different situations. One was not going to come to a mesothelioma center- he was going to stay close to home and have his local doctor treat him. The local doctor was the one uncomfortable with his decision. He wanted the patient to explore some options in a mesothelioma center. He talked to the patient and his family multiple times, educated them on options and now the patient will be seen at a mesothelioma center. The second patient had scoured the internet, and found out as much information as possible, made her own appointment and was also going to be seen at the mesothelioma center.

Communication played a critical part in the mesothelioma journey of both the patients and families. Communication is a two-way street involving listening and talking. Before you make the decisions regarding your treatment options with mesothelioma, be sure to gather the facts, and listen with an open mind to your options. Being comfortable with your care team is essential. Being able to ask the tough questions and hear the answers that are given will help both the patient and the family deal with mesothelioma. Communication styles vary, know what your options are, and what you are comfortable with- it is your journey.

– Lisa

Asking the Mesothelioma Patient: What do You Want to Do?

Posted on January 11, 2017 by Ellie

One of the leading physicians in treating patients with mesothelioma always includes in his first interactions with patients a simple important question to his patients. “What do you want to do?’ It is a non-judgmental question acknowledging the patient has his own thoughts, feelings, and that most importantly the patient oversees what if any treatment choices he makes. This might seem like something that is assumed, a patient seeks out an expert in the field of mesothelioma, he may have traveled a great distance, has a support system that is urging him to do everything he can to stay alive, but he is not sure that the treatment plan is something he wants to go through.

The other day at a conference with two patients and their families that have been recently diagnosed with malignant pleural mesothelioma, two questions came to mind. What do you want to do? What is important to you? Two patients, two spouses, supportive adult children, a roomful of people, including social workers, medical experts, chaplaincy, all talked except the two patients. At the conference, it is a lot of information to absorb, a lot of statistics and different possible scenarios that could happen to the patient. Well-intentioned family members asked lots of questions. All of them were trying their best to find a path for their loved one’s journey with mesothelioma. The two patients sat silent no questions, no visible reactions.

These two patients and their families were just starting on their journey with mesothelioma. The treatment options that are recommended to them are specific to them. Hopefully both will have a long journey with mesothelioma, with a great quality of life during the remainder of their lives. If things do not go well, their families and the team taking care of them will know that the patient was asked two important questions before proceeding with their treatments. “What do you want to do?” “What is important to you?”

The bottom line is that this journey is yours, the patient with mesothelioma. You must make the decisions on how you want, and how you choose, to live your life.

– Ellie

MESOTHELIOMA CENTER REVIEW – HILLMAN CANCER CENTER, UNIVERSITY OF PITTSBURGH

Posted on January 5, 2017 by Ellie and Lisa

It is recommended that when you or your family member is diagnosed with mesothelioma that you be evaluated at an academic, multi-disciplinary, mesothelioma center. To become familiar with what a center can offer, we feature one center a month.

UNIVERSITY OF PITTSBURGH MEDICAL CENTER

Hillman Cancer Center

William Cooper Pavilion Suite 140

5115 Centre Ave.

Pittsburg Pa. 15232

Mission: “At UPMC Cancer Center we’re committed to giving you the knowledge, inspiration, and specialty care you need to boldly face your cancer It’s because no diagnosis should stop you from doing the things you love, or from living each day to the fullest.”

History: Regions only comprehensive cancer institute designated by the National Cancer Institute

Director- James D Luketich M.D.- Chief of the Division of Thoracic and Foregut Surgery

David L. Bartlett M.D.- Director of Multidisciplinary Disease Site Clinical Research Program for UPMC

Team– Specialists from all areas- oncologists that specialize in thoracics, medical oncologists, surgeons, pathologists, radiation oncologists, palliative care all work as a team to deliver the specialized care that is necessary for mesothelioma patients. Led by Dr. James Luketich, the thoracic surgical oncologists include Dr. Neil Christie, Dr. Ryan Levy, Dr. Matthew Schuchert. The surgical oncologists include Dr. David L. Bartlett, Dr. Matthew P. Holtzman, Dr. James F. Pingpank. For a complete list of the team see www.upmccancercenter.com

Affiliations multiple hospitals throughout Pittsburgh

Stats – At the UPMC there are a total of 74,000 patients that are treated for many different cancers. The Mesothelioma patients are treated by experts in both pleural and peritoneal mesothelioma. UPMC is a busy mesothelioma center treating patients from a wide geographical area.

Research- The program is comprised of nine full time research scientists as well as clinical investigators. The research team is focused on many clinical trials; Dr. Bartlett’s specialty is regional delivery of chemotherapy to unresectable metastatic cancers. He has also developed oncolytic viruses for metastatic cancers.

Support Services– “At UPMC Cancer Center we want to take care of your heart and mind, just as we work with you to treat your illness.” Listed resources include:

Center for Counseling and Cancer Support- a team consisting of psychologists and psychiatrists experienced in helping patients and their families deal with living with cancer.

The Sheila Reicher Fine Collection- books, pamphlets, and CDs to help patients and families deal with the many emotions of living with cancer.

Contact- Hillman Cancer Center – 5115 Centre Avenue Pittsburg Pa 15232; Phone: 412-692-4724

Mesothelioma specialized care contact 412-647-2811

MESOTHELIOMA CLINICAL TRIAL REVIEW – HILLMAN CANCER CENTER, UNIVERSITY OF PITTSBURGH

Posted on January 5, 2017 by Ellie and Lisa

For mesothelioma patients and families who are interested in clinical trials, researching clinical trials and eligibility can be a time-consuming barrier to participation. The information about clinical trials is available at www.clinicaltrials.gov.

CLINICAL TRIAL- NCT02151448

ADC1 Vaccine + Chemokine Modulatory Regimen (CKM) as Adjuvant Treatment of Peritoneal Surface Malignancies

Official Title- A Phase ½ Trial Evaluating aDC1 Vaccines Combined With Tumor-Selective Chemokine Modulation as Adjuvant Therapy After Surgical Resection of Peritoneal Surface Malignancies

Listing on www.clinicaltrials.gov

Sponsor: Pawel Kalinski M.D. in collaboration with National Cancer Institute

Location: Hillman Cancer Center Pittsburgh, Pennsylvania

Principal Investigator: David L Bartlett M.D. University of Pittsburgh

Contact: David L. Bartlett MD 412 692 2852 bartlettdl@apmc.edu or Natlaie Streeter BA MSN RN 412 235 1276 streetern@upmc.edu

Number of Participants: 168 participants- Start Date July 2014 Estimated completion December 2017

Purpose: “This trial is to determine the safest dose of a triple combination (chemokine modulatory regimen or CKM) of celecoxib, interferon alpha (IFN), and rinatolimod that can be given with a DC vaccine as treatment of peritoneal surface malignancies ater standard of care surgery.

Eligibility Criteria:

18 years of age candidate for surgical reconstruction. Patient has confirmed malignancy of the peritoneum. Patients may have had extensive prior treatments. An ECOG performance status of 0.1 or 2
Patient must be able to swallow pills.
Patient must have normal organ function as defined below
Platelets greater than 75000, hemoglobin greater than 9/0 hematocrit greater than 27

Exclusion Criteria:

use of steroids must be removed at least 3 weeks’ prior administration of vaccination
History of transplant or autoimmune disease
Patients who are pregnant or nursing
Patients with myocardial infarction or ischemia within 3 months prior to
Allergic reactions to or hypersensitivity to Celcoxib or NSAIDs

How the Research Study is Designed to Work:

The trial will evaluate the safety and effectiveness of triple combinations of celecoxib, interferon and rintatolimod that can be given with a DC vaccine as treatment of peritoneal surface malignancies after standard of care surgery.

The patient must be a surgical candidate with peritoneal mesothelioma. Once this is determined patient will undergo resection at University of Pittsburgh with Dr. Bartlett. While in the operating room, the surgeon will remove a piece of tumor and send it off to the lab. After recovering from surgery patient will have leukaphereses, a lab procedure in which the white blood cells are separated from the blood, it will then be transported to the lab where the tumor is. These two components will be made to form a vaccine. Once recovered from surgery, the treatment of the vaccine will be delivered to the patient. One will be given intradermally (one of the routes of administration used for vaccinations, layer of skin under the epidermis) and one will be given into the lymph nodes. Four weeks after surgery patient will receive intravenous Intraferon which will be given every day, Rintatolimod will be given on Wednesday and Friday of that same week. Celecoxib will be given every day as well during that week. The patient must stay in the Pittsburgh area for these weekly treatments. The goal is to get this regime every 4 weeks. The quality of tumor extracted from the operating room will define how large of a vaccine can be made. If there is residual vaccine it will be up to the patient and team whether administration is continued.

Please contact us if you have any questions.

Mesothelioma Blog

Get Free Assistance with Treatment Questions from Experienced Mesothelioma Nurses

(and receive a Mesothelioma Treatment
and Care Guide)

Handling Challenges on Your Mesothelioma Journey

Ban Asbestos to Prevent Mesothelioma

Mesothelioma Patient Care: Behind The Scenes

MESOTHELIOMA CLINICAL TRIAL REVIEW- GENETICALLY MODIFIED T CELLS IN TREATING PATIENTS WITH STAGE III-IV NON- SMALL CELL LUNG CANCER OR MESOTHELIOMA

MESOTHELIOMA SPECIALIST SPOTLIGHT: DR. FARHOOD FARJAH

MESOTHELIOMA CENTER REVIEW – UNIVERSITY OF WASHINGTON

The Importance of Communication in Your Mesothelioma Journey

Asking the Mesothelioma Patient: What do You Want to Do?

MESOTHELIOMA CENTER REVIEW – HILLMAN CANCER CENTER, UNIVERSITY OF PITTSBURGH

MESOTHELIOMA CLINICAL TRIAL REVIEW – HILLMAN CANCER CENTER, UNIVERSITY OF PITTSBURGH

Get Free Assistance with Treatment Questions from Experienced Mesothelioma Nurses

(and receive a Mesothelioma Treatment
and Care Guide)

Recent Articles

Blogging About Mesothelioma

Mesothelioma Recovery

Talia’s Journey

What do you – the patient – want?

Mesothelioma Blog

Get Free Assistance with Treatment Questions from Experienced Mesothelioma Nurses

(and receive a Mesothelioma Treatment and Care Guide)

Get Free Assistance with Treatment Questions from Experienced Mesothelioma Nurses

(and receive a Mesothelioma Treatment and Care Guide)

Recent Articles

(and receive a Mesothelioma Treatment
and Care Guide)

(and receive a Mesothelioma Treatment
and Care Guide)