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Amerikaanse onderzoekers hebben een virus gevonden dat bij muizen de groei van een mesothelioomgezwel afremt. Virustherapie is erop gericht virussen te vinden die zich alleen in tumorcellen vermenigvuldigen en de normale cellen sparen. Bron: mesothelioma applied research foundation, 25 april 2007. Meer www.marf.orf

Asbestvezels kunnen de eierstokken bereiken. Dat constateerden Noorse onderzoekers bij een groep vrouwen die in een papier- en pulpfabriek hadden gewerkt. Meer onderzoek is nodig om te bepalen of de asbest in de eierstokken ook eierstokkanker kunnen veroorzaken. Bron: Langseth, H. et al. (2007). Asbestos fibers in ovarian tissue from Norwegian pulp and paper workers. International Journal of Gynecological Cancer 17, 44-49.

Langseth, H., Johansen B.V., Nesland, J.M. & Kjaerheim, K. (2007). Asbestos fibers in ovarian tissue from Norwegian pulp and paper workers

Abstract

An elevated risk of ovarian cancer has been observed in Norwegian pulp and paper workers who were possibly occupationally exposed to asbestos. The present study was initiated to investigate if the increased risk could be associated with asbestos fibers in ovarian tissue from workers in this industry. Normal ovarian tissue specimens from three groups of women were included in the study. The case group included specimens from 46 women diagnosed with ovarian cancer in the period 1953-2000, and who had been working in one or more pulp and paper mills between 1920 and 1993. Normal ovarian tissue specimens from two control groups without occupational history from pulp and paper work were selected from the

Cancer Registry database. Tissue blocks were digested and prepared for transmission electron microscopy. Number of fibers per gram wet weight was calculated. Asbestos fibers were found in normal ovarian tissue from two subjects in the case group, while no fibers were found in the control groups. The two asbestos positive cases had been working as paper sorter/packer and chlorine plant worker, respectively. Both were possibly secondary exposed to asbestos from family members working as insulators. We conclude that the findings in this study did not allow drawing any firm conclusion about an association between occupational exposure to asbestos and ovarian cancer in Norwegian pulp and paper workers. Our study confirms that asbestos fibers may reach the ovaries and demonstrates that the applied method is appropriate for identification of the fiber.

Knoflook werkt als een anti-occidant en vermindert daardoor de schadelijke werking van chrysotiel asbest in het bloed. Dit constateerden Indiase en Duitse onderzoekers in een in-vitro studie. Het ging om een reageerbuis-experiment met menselijk bloed. Bron: Yadav, S. (2006). Modulatory Effects of Fresh Garlic Extract on Chrysotile Asbestos Induced Genotoxicity: An In Vitro Study. Bulletin Environmental Contamination and Toxicology 77: 477-483.

De invloed van blootstelling aan asbest in het milieu op het risico op longkanker bij mensen die nooit gerookt hebben is onduidelijk. Longkanker heeft bij mensen die nooit gerookt hebben andere moleculaire en biologische kenmerken dan bij rokers. Twee recente overzichtsstudies beschrijven dat niet-rokende vrouwen vaker longkanker krijgen dan niet-rokende mannen: tussen de 15 en 25% van de vrouwelijke longkankerpatiënten heeft nooit gerookt, bij mannelijke longkankerpatiënten is dat tussen de 5 en 10%. Bron: Wakelee H.A. et al. (2007). Lung cancer incidence in never smokers. Journal of Clinical Oncology, Feb 10.25(5):469-71. Subramanian, J. & Govindan, R. (2007). Lung cancer in never smokers: a review. Journal of Clinical Oncology feb 10. 25(5), 561-70.
Wakelee H.A., Chang ET, Gomez SL, Keegan TH, Feskanich D, Clarke CA, Holmberg L, Yong LC, Kolonel LN, Gould MK, West DW (2007). Lung cancer incidence in never smokers. Journal of Clinical Oncology, Feb 10.25(5):469-71.

PURPOSE: Lung cancer is a leading cause of cancer death worldwide. Although smoking remains the predominant cause of lung cancer, lung cancer in never smokers is an increasingly prominent public health issue. However, data on this topic, particularly lung cancer incidence rates in never smokers, are limited. METHODS: We reviewed the existing literature on lung cancer incidence and mortality rates among never smokers and present new data regarding rates in never smokers from the following large, prospective cohorts: Nurses’ Health Study. Health Professionals Follow-Up Study. California Teachers Study. Multiethnic Cohort Study. Swedish Lung Cancer Register in the Uppsala/Orebro region. and First National Health and Nutrition Examination Survey Epidemiologic Follow-Up Study. RESULTS: Truncated age-adjusted incidence rates of lung cancer among never smokers age 40 to 79 years in these six cohorts ranged from 14.4 to 20.8 per 100,000 person-years in women and 4.8 to 13.7 per 100,000 person-years in men, supporting earlier observations that women are more likely than men to have non-smoking-associated lung cancer. The distinct biology of lung cancer in never smokers is apparent in differential responses to epidermal growth factor receptor inhibitors and an increased prevalence of adenocarcinoma histology in never smokers. CONCLUSION: Lung cancer in never smokers is an important public health issue, and further exploration of its incidence patterns, etiology, and biology is needed.

Subramanian, J. & Govindan, R. (2007). Lung cancer in never smokers: a review. Journal of Clinical Oncology feb 10. 25(5), 561-70.

ABSTRACT

Lung cancer is the leading cause of cancer-related death in the United States. Although tobacco smoking accounts for the majority of lung cancer, approximately 10% of patients with lung cancer in the United States are lifelong never smokers. Lung cancer in the never smokers (LCINS) affects women disproportionately more often than men. Only limited data are available on the etiopathogenesis, molecular abnormalities, and prognosis of LCINS. Several etiologic factors have been proposed for the development of LCINS, including exposure to radon, cooking fumes, asbestos, heavy metals, and environmental tobacco smoke, human papillomavirus infection, and inherited genetic susceptibility. However, the relative significance of these individual factors among different ethnic populations in the development of LCINS has not been well-characterized. Adenocarcinoma is the predominant histologic subtype reported with LCINS. Striking differences in response rates and outcomes are seen when patients with advanced non-small-cell lung cancer (NSCLC) who are lifelong never smokers are treated with epidermal growth factor receptor tyrosine kinase (EGFR-TK) inhibitors such as gefitinib or erlotinib compared with the outcomes with these agents in patients with tobacco-associated lung cancer. Interestingly, the activating mutations in the EGFR-TK inhibitors have been reported significantly more frequently in LCINS than in patients with tobacco-related NSCLC. This review will summarize available data on the epidemiology, risk factors, molecular genetics, management options, and outcomes of LCINS.

Volgens patholoog Gibb en collega’s is de in 1997 in Helsinki overeengekomen methode om de relatie tussen asbestblootstelling en longkanker vast te stellen aan de hand van een schatting van de asbestblootstellingsfrequentie, intensiteit en het aantal vezeljaren niet nauwkeurig. Het samengaan met asbestose, een andere asbestziekte, lijkt op dit moment nog het meest betrouwbare criterium om vast te stellen dat longkanker door asbestblootstelling is veroorzaakt. Sorgdrager schrijft dat de invloed van roken de causaliteitsvraag nog moeilijker maakt. Sinds 1975 worden bijna 3000 intensief aan blauw asbest blootgestelde ex-werknemers uit het Australische Wittenoom periodiek gevolgd. In deze populatie blijkt het asbesteffect op het risico op longkanker tussen rokers en niet-rokers niet significant verschillend. Andere specifieke populatiekenmerken lijken van groter belang. Dit is opmerkelijk omdat inmiddels in de wetenschap steeds meer aangenomen wordt dat roken en asbest samen het risico op longkanker vergroten. Bron: Gibbs, A. et al. (2007). The “Helsinki Criteria” for attribution of lung cancer to asbestos exposure. How robust are the Criteria. Editorial. Arch Pathol Lab Med 131, february, 181-184. Sorgdrager, B. (2007). Longkanker en asbest, hoe zit het met de rol van sigaretten? Referaat. TBV 15, 2, 88-89.

Het Amerikaanse “National Institute for Occupational Safety and Health (NIOSH)” heeft in een beleidsdocument geadviseerd nieuw onderzoek te doen naar welke asbestkenmerken gezondheidsrisico’s veroorzaken bij beroepsmatige blootstelling. Het document vermeldt een aantal vragen waarop op dit moment wetenschappelijk nog geen eenduidig antwoord te geven is. Het instituut wil hiermee de publieke dialoog op gang brengen. Bron: Niosh, 12 maart 2007. Meer www.cdc.gov

De Amerikaanse “Food and Drug Administration” heeft de Mesomark bloedtest goedgekeurd als middel in het onderzoek naar mesothelioom. Met deze test wordt de hoeveelheid mesotheline in het bloed gemeten, die aanwijzingen geeft over de grootte van een mesothelioom gezwel. De test kan gebruikt worden om te meten hoeveel effect een behandeling op een patiënt heeft. De Mesomark test, waarvoor alleen een bloedmonster nodig is, kan daarom misschien een alternatief zijn voor andere belastende en kostbare testmethodes die gebruikt worden. In Europa wordt de test momenteel beoordeeld voor klinisch gebruik. Bron: Mesothelioma Applied Research Foundation, 25 januari 2007. Meer www.marf.org

Chemotherapie met een combinatie van de middelen pemetrexed (Alimta) en cisplatine kan de levensduur met ca. 3 maanden verlengen bij een selecte groep mesothelioompatiënten met een goede functionele capaciteit (performance status). Dit concluderen Green et al. na analyse van de resultaten van een studie van 448 patiënten die in 20 verschillende centra over de wereld behandeld waren. Bron: Green J. et al. (2007). Pemetrexed disodium in combination with cisplatin versus other cytotoxic agents or supportive care for the treatment of malignant pleural mesothelioma. Cochrane Database of Systematic Reviews 2007, Issue 1. Art. No.: CD005574. DOI: 10.1002/14651858. CD005574.pub2.

Green J, Dundar Y, Dodd S, Dickson R, Walley T. Pemetrexed disodium in combination with cisplatin versus other cytotoxic agents or supportive care for the treatment of malignant pleural mesothelioma. Cochrane Database of Systematic Reviews 2007, Issue 1. Art. No.: CD005574. DOI: 10.1002/14651858.CD005574.pub2.

BackgroundMalignant pleural mesothelioma (MPM) is a highly aggressive malignancy whose incidence is expected to increase in the United Kingdom,Western Europe, and Australia over the next 20 years as a result of occupational exposure to asbestosfibres. Surgery is feasible in only a small proportion of cases, and radiotherapy and cytotoxic chemotherapy are used in palliation. Pemetrexed is the first and only chemotherapy agent that has been granted a marketing approval for use in combination with cisplatin for the treatment of chemonaïve patients with unresectable MPM.

Objectives

To examine evidence on the clinical effectiveness of pemetrexed disodium used in combination with cisplatin for the treatment of unresectable malignant pleural mesothelioma in chemotherapy naïve patients compared with other cytotoxic agents used alone or in combination, or supportive care.

Search strategy

CENTRAL (Issue 2, 2005), EMBASE (1980-2005), MEDLINE (1980-2005), HTA database (1990-2005),Web of Knowledge (1990- 2005) and handsearching (including reference lists of retrieved articles and the pharmaceutical company submission to to NICE), up to October 2005.

Selection criteria

Randomised Controlled Trials (RCTs) where the use of pemetrexed disodium in combination with cisplatin is compared with other cytotoxic agents, or supportive care for the treatment of malignant pleural mesothelioma (or non-RCTs, in the absence of RCT data ).

Data collection and analysis

Outcomes included overall survival, tumour response, progression-free survival, toxicity and quality of life. Data extraction and quality assessment of included trials was completed independently. Trial data and quality assessment were tabulated and presented narratively.

Main results

One RCT involving 448 patients and comparing pemetrexed plus cisplatin versus cisplatin alone for the treatment of unresectable malignant mesothelioma was included in the review. In the intention-to-treat study population, the median survival was statistically significantly longer in the combination arm of pemetrexed plus cisplatin when compared with the cisplatin alone arm. (12.1 and 9.3 months, respectively, p=0.002). The incidence of grade 3/4 toxicities was higher in the combination arm compared with the cisplatin alone arm

Authors’ conclusionsPemetrexed disodium in combination with cisplatin and with folic acid and vitamin B12supplementation may improve survival when used in combination with cisplatin in good performance status patients. Further studies including patients with poor performance status are needed in order to generalise the treatment findings. Further studies are also needed into the optimum chemotherapy, and a clear definition of what constitutes best supportive care.

Ratten die met “boysenberries”m, een grote bramensoort, zijn gevoed ontwikkelen minder vaak symptomen van mesothelioom door asbest. De bramen die in de VS en Nieuw Zeeland groeien kunnen rauw of in jam verwerkt gegeten worden. De beschermende werking komt volgens de Japanse onderzoekers door de stof polyphenol die in deze soort bramen in grote concentratie voorkomt. Bron: The Yomiuri Shimbun, 8 februari 2007.

Een meta-analyse van de resultaten van drie case-control studies geeft aan dat asbestblootstelling het risico op longkanker 1,67 keer vergroot. Bron: Mahjub H & Sadri GH, (2006). Meta-analysis of case-referent studies of specific environmental or occupational pollutants on lung cancer. Indian Journal of Cancer, october-december, 43, 4, 169-173.