Sanjay Popat, BSc, MBBS, FRCP, PhD, The Royal Marsden NHS Foundation Trust, London, UK, describes updates in the field of mesothelioma. Immunotherapy for patients who progress from chemotherapy have demonstrated mixed results, with the PROMISE-meso trial (NCT02991482) showing pembrolizumab to not be as efficacious as standard chemotherapy. However, nivolumab plus ipilimumab resulted in superior survival in the CONFIRM (NCT03063450) and CheckMate 743 (NCT02899299) trials. Prof. Popat additionally recommends immunotherapy in non-epithelioid mesothelioma in the first line setting. This interview took place at the 20th Annual British Thoracic Oncology Group (BTOG) Conference 2022.

Experts from the Penn Mesothelioma and Pleural Program discuss risk factors, primarily exposure to asbestos, can increase the chances of developing mesothelioma.

Patient Bio:

Retired physician from Detroit, Michigan, Dr. Charles Reaume never considered that he had lung cancer; his symptoms had gone unnoticed. After having fluid removed from his lung 3-4 times, his physician told him he noticed some cells that looked suspicious. Then, after receiving a biopsy he was told he had a rare form of lung cancer disease – Mesothelioma.

After receiving the prognosis of lung cancer (Mesothelioma) Dr. Charles Reaume immediately became concern with lung cancer life expectancy and sought to find a lung cancer doctor who specializes in Mesothelioma. He decided to travel to see Dr. David Sugarbaker a well renowned physician who treats this rare form of lung cancer. He was also one of the very few patients to be seen as a lung cancer patient at the new Mesothelioma Treatment Center at Baylor College of Medicine in Houston Texas. After Dr. Reaume’s initial visit, he later had lung cancer treatment and surgery completed. He is now over a year out from his treatment and doing wonderfully.

Symptoms:

Signs of lung cancer in men regarding asbestos exposure can often go unnoticed and later develop into a mesothelioma case. Asbestos gets trapped in the thin lining layer around the lung. Patients with prognosis of lung cancer Mesothelioma can have some of these common lung cancer symptoms:

Chest wall pain
Fatigue
Night sweats / fever
Weight loss
Persistent coughing or wheezing
Difficulty swallowing
Shortness of breath

Their search/story:

Dr. Charles Reaume wasn’t aware he was exposed to asbestos dust. He lived his life without any signs and symptoms of lung cancer until his local doctor decided to take an extra look. His primary doctor told him that the hunt for asbestos cure still lives on in medical research today, but there is unfortunately no cure for asbestos lung cancer. He did mention that there are very effective treatments available to treat this form of lung cancer caused by asbestos. After Dr. Reaume received a lung cancer stage diagnosis, he went in search of a mesothelioma doctor. His primary questions were: “Is lung cancer curable?” and “Is asbestos disease a death sentence?”

Dr. Charles Reaume was referred to an asbestos doctor - Dr. Sugarbaker. Dr. Sugarbaker is a highly regarded physician who is a pioneer in treating asbestos disease and mesothelioma cancer. Dr. Sugarbaker’s effective method is to remove the effected tissue exposed to asbestos as much as possible from the lung thus eliminating cancer from the body and hoping to increase the likelihood of a patients’ life expectancy.

Dr. Sugarbakers Profile:
Dr. Sugarbaker is a leading physician when it comes to treating lung cancer caused by asbestos. His years of experience have made him internationally recognized as a physician that can treat lung cancer and remove effected tissue exposed to asbestos. It’s no wonder that patients from all over the world seek out Dr. Sugarbaker for asbestosis treatment. Dr. Sugarbaker has developed a “3 part lung treatment approach” when treating malignant pleural mesothelioma. Dr. Sugarbaker’s 3 part treatment approach encompasses radiation therapy, chemotherapy, and radical surgery to treat his patients with mesothelioma.

Lung Cancer Asbestos Treatment:

Ongoing medical research is looking for a cure for lung cancer. However, this rare form known as Mesothelioma has a few effective treatment options:

Sugarbaker’s lung cancer asbestos removal procedures are:

• Extrapleural pneumonectomy (EPP) – a procedure Dr. Sugarbaker spent 25 years of his career perfecting. . EPP surgically removes the cancerous lung and some of its surroundings. EPP candidates must typically meet the following criteria: an early stage cancer diagnosis; relatively good health; and normal heart and kidney function.

• Pleurectomy - a lung-sparing surgical procedures that removes the lining layers (the pleura) and nearby tumors, . Candidates eligible for pleurectomy are typically Stage 1 cancer patients and in good health.

• Chemotherapy – part of Dr. Sugarbaker’s multi-modal treatment approach. Chemotherapy is employed after surgery to destroy any remaining cancer. Dr. Sugarbaker has been developing a more targeted form of chemotherapy that attacks cancer cells at the molecular level.

• Radiation –also part of Dr. Sugarbaker’s treatment toolbox. Extra beam radiation therapy is employed after surgery to eradicate remaining cancer.


After Treatment:
Dr. Charles Reaume fought Mesothilioma with the help of Dr. Sugarbaker and is now an Asbestos lung cancer survivor. When Dr. Charles Reaume was first diagnosed with lung cancer he was told he would only live up to 6 months. It has been a year and a half, and he enjoys his life to the fullest with his lovely wife. His favorite activities are walking and visiting family members. He is proud to be a mesothelioma lung cancer survivor.

Dean Fennell, FRCP, PHD, University Hospitals of Leicester NHS Trust, Leicester, UK, discusses precision medicine in mesothelioma, highlighting the main challenges associated with the implementation of personalized medicine, including the prevalence of tumor suppressor genes which are not typically associated as druggable targets, as well as the potential of umbrella trials in mesothelioma. This interview took place at the European Lung Cancer Congress 2023 in Copenhagen, Denmark.

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