Greetings, dear readers! We are excited to share with you the latest updates and insights from the recently held International Mesothelioma 2018 Conference, which marked its 15th year of gathering esteemed healthcare professionals, experts, and advocates in the field of mesothelioma research and care.
The conference was held on October 5-7, 2018, at the Hilton Americas-Houston in Texas, USA. It featured a comprehensive program that aimed to improve the understanding, diagnosis, treatment, and prevention of mesothelioma, a rare and deadly cancer caused by asbestos exposure.
Since mesothelioma is a complex and multifaceted disease, the conference tackled various topics such as epidemiology, pathology, imaging, clinical trials, surgery, chemotherapy, radiation therapy, immunotherapy, palliative care, and patient advocacy. It also highlighted the need for multidisciplinary collaboration and innovation to address the challenges posed by mesothelioma.
In this article, we will delve deeper into the highlights, key messages, and takeaways from the conference. We hope that this will serve as a valuable resource for healthcare professionals, patients, caregivers, advocates, and anyone interested in mesothelioma research and care.
Welcome Remarks and Mesothelioma Awareness Month
The conference started with a warm welcome from the organizers, including Dr. David Sugarbaker, who is an internationally recognized mesothelioma expert from Baylor College of Medicine. He highlighted the significance of the conference in advancing mesothelioma science and improving patient outcomes.
Dr. Sugarbaker also acknowledged that October is Mesothelioma Awareness Month, which aims to raise public awareness about the dangers of asbestos exposure and the impact of mesothelioma on individuals and families. He emphasized that mesothelioma is not just a medical problem, but also a social, economic, and political issue that requires collective action.
Table 1: International Mesothelioma 2018 Conference Overview
| Date | Session | Topic | Speaker |
|---|---|---|---|
| Oct. 5 | Plenary Session | Mesothelioma Epidemiology and Prevention | Dr. Michele Carbone, University of Hawaii |
| Oct. 5 | Plenary Session | Mesothelioma Pathology and Molecular Biology | Dr. Andrew Churg, University of British Columbia |
| Oct. 5 | Plenary Session | Mesothelioma Imaging and Staging | Dr. Richard Alexander, Memorial Sloan Kettering Cancer Center |
| Oct. 5 | Concurrent Session | Mesothelioma Surgery and Multimodality Therapy | Dr. Marcello Deraco, National Cancer Institute of Milan |
| Oct. 5 | Concurrent Session | Mesothelioma Chemotherapy and Targeted Therapy | Dr. Dean Fennell, University of Leicester |
| Oct. 5 | Concurrent Session | Mesothelioma Radiation and Immunotherapy | Dr. Charles Simone, New York Proton Center |
| Oct. 6 | Plenary Session | Mesothelioma Clinical Trials and Drug Development | Dr. Anne Tsao, University of Texas MD Anderson Cancer Center |
| Oct. 6 | Plenary Session | Mesothelioma Palliative Care and Quality of Life | Dr. Marie Bakitas, University of Alabama at Birmingham |
| Oct. 6 | Concurrent Session | Mesothelioma Advocacy and Support | Ms. Linda Reinstein, Asbestos Disease Awareness Organization |
| Oct. 6 | Concurrent Session | Mesothelioma Environmental Justice and Litigation | Mr. Brent Kynoch, Environmental Information Association |
| Oct. 6 | Concurrent Session | Mesothelioma International Perspectives and Challenges | Dr. Nico van Zandwijk, International Mesothelioma Interest Group |
| Oct. 7 | Plenary Session | Mesothelioma Roundtable and Recommendations | All Speakers and Attendees |
Epidemiology and Prevention: Understanding the Burden and Risk Factors of Mesothelioma
The first plenary session of the conference centered on the epidemiology and prevention of mesothelioma, which is crucial in identifying the scope of the disease and developing strategies to lower its incidence. Dr. Michele Carbone, a renowned mesothelioma researcher from the University of Hawaii, presented the latest data on the global burden of mesothelioma and the role of asbestos exposure in causing the disease.
According to Dr. Carbone, mesothelioma affects around 3,000 to 5,000 people per year in the United States, and the numbers are expected to rise in the coming years due to the long latency period of the disease. He also emphasized that asbestos, a naturally occurring mineral used in various industries such as construction, shipbuilding, and automotive, is the primary cause of mesothelioma, accounting for about 80% of cases.
Despite the known dangers of asbestos, its use is still prevalent in many countries, particularly in developing ones. Dr. Carbone urged governments, organizations, and individuals to take concrete actions to eliminate asbestos exposure and mitigate its health effects. He also highlighted the importance of early detection and intervention in reducing the mortality and morbidity of mesothelioma.
Pathology and Molecular Biology: Unraveling the Mechanisms and Markers of Mesothelioma
The second plenary session of the conference focused on the pathology and molecular biology of mesothelioma, which involves studying the cellular and genetic changes that occur in the disease. Dr. Andrew Churg, a leading pathologist from the University of British Columbia, discussed the latest findings on mesothelioma subtypes, biomarkers, and therapeutic targets.
Dr. Churg explained that mesothelioma is not a uniform disease, but rather a spectrum of tumors with distinct histologic features and clinical behaviors. He cited three primary subtypes of mesothelioma: epithelioid, sarcomatoid, and biphasic, each with different prognoses and responses to treatment. He also presented several biomarkers and genetic abnormalities that can aid in the diagnosis, differentiation, and monitoring of mesothelioma, such as BRCA1-associated protein 1 (BAP1) and cyclin-dependent kinase inhibitor 2A (CDKN2A).
Moreover, Dr. Churg highlighted some promising targets for mesothelioma therapy, such as the tumor protein 53 (TP53) pathway, the focal adhesion kinase (FAK) pathway, and the immune checkpoint inhibitors, which aim to enhance the immune system’s ability to recognize and attack cancer cells. He noted that these approaches are still in the early stages of development, but may provide new options for mesothelioma patients in the future.
Imaging and Staging: Maximizing the Accuracy and Utility of Mesothelioma Diagnosis and Assessment
The third plenary session of the conference dealt with the imaging and staging of mesothelioma, which plays a crucial role in determining the extent, location, and characteristics of the disease. Dr. Richard Alexander, a radiologist from Memorial Sloan Kettering Cancer Center, shared the latest advancements and challenges in mesothelioma imaging and staging.
Dr. Alexander noted that traditional imaging modalities such as chest X-ray, computed tomography (CT), and magnetic resonance imaging (MRI) have limitations in detecting mesothelioma, as the disease can mimic other conditions and present with varying degrees of aggression. Therefore, he emphasized the use of more specialized and novel imaging techniques such as positron emission tomography (PET), PET-CT, and diffusion-weighted MRI, which can provide better accuracy and sensitivity in mesothelioma detection and monitoring.
Additionally, Dr. Alexander discussed the importance of proper mesothelioma staging, which involves classifying the disease into four stages based on its size, locati
on, and spread. He explained that staging is essential in determining the appropriate treatment options and predicting the prognosis of mesothelioma patients. He also presented the latest staging systems and guidelines for mesothelioma, such as the Brigham and Women’s Hospital (BWH) staging system and the International Mesothelioma Interest Group (IMIG) guidelines.
Surgery and Multimodality Therapy: Enhancing the Curative and Palliative Options for Mesothelioma
The first concurrent session of the conference focused on the surgery and multimodality therapy of mesothelioma, which aims to remove or reduce the tumor burden while minimizing the side effects and complications. Dr. Marcello Deraco, a surgical oncologist from the National Cancer Institute of Milan, presented the latest trends and controversies in mesothelioma surgery and multimodality therapy.
Dr. Deraco highlighted that surgery remains the primary curative option for mesothelioma, as it can remove the visible tumor and prolong survival in select patients. However, he also emphasized that not all mesothelioma patients are suitable for surgery, as the disease may have spread too far or affect vital organs. He discussed the different surgical techniques and approaches for mesothelioma, such as extrapleural pneumonectomy (EPP), pleurectomy/decortication (P/D), and extended pleurectomy/decortication (EP/D).
Furthermore, Dr. Deraco discussed the role of multimodality therapy in mesothelioma, which involves combining two or more treatment modalities such as surgery, chemotherapy, and radiation therapy. He pointed out that multimodality therapy can enhance the effectiveness and safety of mesothelioma treatment by targeting different aspects of the disease and avoiding overdosing on a single modality. However, he also cautioned that multimodality therapy may increase the complexity and costs of mesothelioma care, and require close coordination among different healthcare providers.
Chemotherapy and Targeted Therapy: Integrating the Latest Agents and Approaches into Mesothelioma Care
The second concurrent session of the conference focused on the chemotherapy and targeted therapy of mesothelioma, which involves using drugs or agents that can kill or inhibit cancer cells while sparing normal cells. Dr. Dean Fennell, a medical oncologist from the University of Leicester, presented the latest update and perspectives on mesothelioma chemotherapy and targeted therapy.
Dr. Fennell explained that chemotherapy is the most common systemic treatment for mesothelioma, as it can reach cancer cells throughout the body and improve symptoms and survival in some patients. However, he also acknowledged that chemotherapy has its limitations, such as toxicity, resistance, and suboptimal response rates. Therefore, he presented some new agents and combinations that are currently being tested in mesothelioma clinical trials, such as pembrolizumab, nivolumab, durvalumab, and tremelimumab, which are immune checkpoint inhibitors that can enhance the immune response against mesothelioma.
Moreover, Dr. Fennell discussed the potential of targeted therapy in mesothelioma, which involves using drugs that can specifically target the molecular or genetic abnormalities of mesothelioma cells. He noted that targeted therapy is still in its infancy in mesothelioma, but some promising targets and agents have been identified, such as inhibitors of mesothelin, fibroblast growth factor receptor (FGFR), and tyrosine kinase receptor (TKR).
Radiation and Immunotherapy: Harnessing the Power of Radiation and the Immune System against Mesothelioma
The third concurrent session of the conference focused on the radiation and immunotherapy of mesothelioma, which aims to kill or control cancer cells by using high-energy radiation or stimulating the immune system. Dr. Charles Simone, a radiation oncologist from New York Proton Center, presented the latest developments and challenges in mesothelioma radiation and immunotherapy.
Dr. Simone explained that radiation therapy is a common local treatment for mesothelioma, as it can deliver high doses of radiation to the tumor while sparing the surrounding normal tissues. However, he also acknowledged that radiation therapy has some side effects and limitations, such as inducing inflammation, fibrosis, and secondary cancers. Therefore, he presented some new techniques and modalities that can improve the safety and effectiveness of mesothelioma radiation therapy, such as intensity-modulated radiation therapy (IMRT), proton therapy, and photodynamic therapy (PDT).
Furthermore, Dr. Simone discussed the potential of immunotherapy in mesothelioma, which involves using drugs or agents that can stimulate or enhance the immune system’s ability to recognize and attack cancer cells. He noted that immunotherapy has emerged as a promising and transformative approach in various types of cancer, and that mesothelioma may also benefit from its therapeutic effects. He presented some of the immunotherapy agents and strategies that are currently being tested in mesothelioma clinical trials, such as checkpoint inhibitors, chimeric antigen receptor (CAR) T-cell therapy, and cancer vaccines.
Clinical Trials and Drug Development: Shaping the Future of Mesothelioma Treatment and Research
The fourth plenary session of the conference tackled the clinical trials and drug development of mesothelioma, which involves testing new therapies, agents, or combinations in human subjects to determine their safety and effectiveness. Dr. Anne Tsao, a medical oncologist from the University of Texas MD Anderson Cancer Center, presented the latest updates and challenges in mesothelioma clinical trials and drug development.
Dr. Tsao emphasized that clinical trials are an essential and ethical way to advance mesothelioma treatment and research, as they provide the opportunity for patients to access potentially beneficial therapies and contribute to the knowledge and understanding of the disease. She noted that mesothelioma clinical trials have evolved over the years, from single-agent trials with low response rates to combination trials with better outcomes and biomarker-driven trials with personalized approaches.
Moreover, Dr. Tsao presented some of the ongoing and upcoming mesothelioma clinical trials and drug development programs that aim to address the unmet needs and challenges of mesothelioma, such as mesothelin-targeted CAR T-cell therapy, BAP1-targeted inhibitors, and novel immunotherapy combinations. She also highlighted the importance of efficient and effective clinical trial design and management, which requires collaboration among various stakeholders and adherence to ethical and regulatory standards.
Palliative Care and Quality of Life: Improving the Symptoms and Support for Mesothelioma Patients
The second plenary session of the conference focused on the palliative care and quality of life of mesothelioma patients, which involves providing relief from symptoms and improving the emotional, social, and spiritual aspects of care. Dr. Marie Bakitas, a palliative care expert from the University of Alabama at Birmingham, presented the latest insights and innovations in mesothelioma palliative care and quality of life.
