Search

Background and objectives: Due to difficulties in identifying sufficient‐sized cohorts there remains uncertainty about prognostic and clinical differences that may be unique to asbestos‐related lung cancer (ARLC). In this study, we use the Helsinki Criteria to define a group of ex‐workers with lung cancer attributable to asbestos exposure and investigate differences that may exist. Methods: A total of 529 patients seeking workers' compensation for their lung cancer were assigned to either ARLC or the non‐ARLC based on parameters defined in the Helsinki Criteria. Clinical and survival details were collected and analyzed. Results: In our study population, ARLC patients were on average older (72.1 ± 7.8) than non‐ARLC patients (66.5 ± 10.2, P < 0.001) and were more likely to be diagnosed as a result of incidental findings or screening program (P < 0.001). The groups were similar in terms of clinical characteristics with the only difference being that plaques were more prevalent among ARLC patients (P < 0.001). Differences were observed for median overall survival (OS), ARLC (9 months) and non‐ARLC (13 months, P = 0.005), as well for treatment (P = 0.01). After adjusting for age, however, these differences disappeared. Conclusions: Age at diagnosis, pleural plaques, and asymptomatic presentation were the attributes that we identified as significantly different between asbestos‐related cancer and other lung cancers. In this cohort, ARLC patients were older diagnosis and with worse overall survival. [ABSTRACT FROM AUTHOR]

See relatedarticle [ABSTRACT FROM AUTHOR]

Malignant pleural mesothelioma ( MPM) is an aggressive malignancy with very limited therapeutic options. Fibroblast growth factor ( FGF) signals play important roles in mesothelioma cell growth. Several FGFs and FGF receptors ( FGFRs) are predicted targets of the miR-15/16 family, which is downregulated in MPM. The aim of this study was to explore the link between the miR-15/16 family and the FGF axis in MPM. Expression analyses via RT- qPCR showed downregulation of the FGF axis after transfection with miR-15/16 mimics. Direct interaction was confirmed by luciferase reporter assays. Restoration of miR-15/16 led to dose-dependent growth inhibition in MPM cell lines, which significantly correlated with their sensitivity to FGFR inhibition. Treatment with recombinant FGF2 prevented growth inhibition and further reduced the levels of FGF/R-targeting micro RNAs, indicating a vicious cycle between miR-15/16 down- and FGF/ FGFR signaling upregulation. Combined inhibition of two independent miR-15/16 targets, the FGF axis and Bcl-2, resulted in additive or synergistic activity. Our data indicate that post-transcriptional repression of FGF-mediated signals contributes to the tumor suppressor function of the micro RNA-15/16 family. Inhibiting hyperactivated FGF signals and Bcl-2 might serve as a novel therapeutic combination strategy in MPM. [ABSTRACT FROM AUTHOR]

ABSTRACT Background and objective Whilst the impact of clinicopathological factors on the prognosis of malignant pleural mesothelioma ( MPM) is well understood, socioeconomic and geographic factors have received less attention. We analysed the relationship between geographic and socioeconomic factors upon survival and treatment provision in a large series of patients with MPM. Methods We assessed MPM patients awarded compensation between 2002 and 2009 with additional MPM incidence data from the New South Wales ( NSW) Cancer Registry. The impact of geographic remoteness, distance from oncological multidisciplinary team ( MDT) and Index of Relative Socioeconomic Advantage and Disadvantage ( IRSAD) upon survival, clinical features and treatment received was analysed. Results We identified 910 patients (67% residing in major cities; 92% <50 km from MDT). Median overall survival was 10.0 months. On multivariate analysis, age >70 (hazard ratio ( HR) = 1.39), male gender ( HR =1.36), non-epithelioid histological subtype ( HR = 2.18) and IRSAD status by decreasing quintile ( HR = 1.06) were independent prognostic factors. There was no significant advantage for patients residing in major cities (10.6 months vs 8.8 months; P = 0.162) or within 50 km of MDT (10.3 months vs 7.8 months; P = 0.539). Patient's geographic location and distance to MDT did not impact chemotherapy, adjuvant radiotherapy or extrapleural pneumonectomy provision. Socioeconomically disadvantaged patients were significantly less likely to receive chemotherapy (37.4% vs 54.8%; P = 0.001). Conclusion This study provides evidence for differences in the treatment and survival according to socioeconomic status for compensated MPM patients in NSW. Further research is warranted to seek additional explanations for the differences noted by comparing the treatments and outcomes of compensated and non-compensated MPM patients in NSW. [ABSTRACT FROM AUTHOR]

Background Prognosis of malignant pleural mesothelioma (MPM) is poor, and predicting the outcomes of treatment is difficult. Here we investigate the potential of microRNA expression to estimate prognosis of MPM patients. Methods Candidate microRNAs from microarray profiling of tumor samples from 8 long (median: 53.7 months) and 8 short (median: 6.4 months) survivors following extrapleural pneumonectomy (EPP) were validated by RT-qPCR in 48 additional EPP samples. Kaplan–Meier log ranking was used to further explore the association between microRNA expression and overall survival (OS). Binary logistic regression was used to construct a microRNA signature (miR-Score) that was able to predict an OS of ≥20 months. Performance of the miR-Score was evaluated by receiver operating characteristic (ROC) curve analysis and validated in a series of 43 tumor samples from patients who underwent palliative surgery [pleurectomy/decortication (P/D)]. Results The miR-Score, using expression data of six microRNAs (miR-21-5p, -23a-3p, -30e-5p, -221-3p, -222-3p, and -31-5p), enabled prediction of long survival with an accuracy of 92.3% for EPP and 71.9% for palliative P/D. Hazard ratios for score-negative patients were 4.12 (95% CI: 2.03–8.37) for EPP and 1.93 (95% CI: 1.01–3.69) for P/D. Importantly, adding the miR-Score to a set of clinical selection criteria (histology, age, gender) increased predictive accuracy in the independent validation set from 76.3% for clinical factors only to 87.3%. Conclusions This study has identified a novel 6-microRNA signature (miR-Score) that can accurately predict prognosis of MPM patients. [ABSTRACT FROM AUTHOR]

Background. Patients with head and neck squamous cell carcinoma (HNSCC) are at risk for developing both pulmonary metastasis and second primary lung cancer (SPLC). The objective of this study was to determine survival characteristics of patients with pulmonary lesions after curative treatment for HNSCC. Methods. Lung resection or biopsy specimens of 36 patients, curatively treated for HNSCC between 1978 and 2002, were defined as second primary squamous cell lung cancer or metastasis by loss of heterozygosity (LOH analysis). Twenty-two of them underwent surgical resection. Survival characteristics were estimated using Kaplan-Meier analysis according to the LOH characterization. Results. The number of resected lung lesions ranged from 1 to 3. Median overall survival after lung surgery was 23.1 months for SPLC (n = 14) and 25.1 months for lung metastases (n = 8). Fourteen patients, SPLC (n = 6) and metastases (n = 8), did not undergo surgical resection, and their median overall survival was 3.7 and 4.4 months, respectively. Conclusion. Survival after resection of metachronic lung lesions following curative treatment of HNSSC is similar for lesions characterized as second primary squamous cell lung cancer and those characterized as metastases. © 2008 Wiley Periodicals, Inc. Head Neck, 2009 [ABSTRACT FROM AUTHOR]

Background High-resistance heat and moisture exchangers (HMEs) have been reported to increase transcutaneous oxygenation (tcpO2) values in laryngectomized individuals and to negatively influence patient compliance. The goal of the present study was to validate earlier published results on short-term transcutaneous oxygenation changes by high-resistance HMEs. Methods We conducted a randomized crossover study, monitoring the influence of an HME on tcpO2 over a 2-hour time interval in 20 subjects. Results No evidence of an immediate HME effect (95% CI: -14.9–13.3 mm Hg, p = .91), or a time-dependent HME effect (95% CI: -.121 – .172 mm Hg/minute, p = .74), on tcpO2 was found. After fitting the statistical model without time dependency, again no evidence of HME presence was seen (95% CI: -.5 mm Hg – 3.6 mm Hg, p = .15). Conclusion In contrast to earlier suggestions, there is no evidence of increased tcpO2 levels by high-resistance HMEs in laryngectomized individuals. Thus, using such HMEs has no added clinical value in this respect. © 2007 Wiley Periodicals, Inc. Head Neck, 2007 [ABSTRACT FROM AUTHOR]

The article discusses the multidisciplinary approach used by the Asbestos Diseases Research Institute (ADRI) to prevent the burden of asbestos-related disease in Australia. It states that the institute drafted guidelines for diagnosis and treatment of malignant pleural mesothelioma (MPM) and establishment of biobank for research into biology of mesothelioma. It mentions the re-establishment of Australian Mesothelioma Registry (AMR).