Pulmonary Toxicity and Malignant Mesotheliomas

Pulmonary Toxicity and Malignant Mesotheliomas

Another interesting study is called, “Potential Role of Histone Deacetylase Inhibitors in Mesothelioma: Clinical Experience with Suberoylanilide Hydroxamic Acid
Clinical Lung Cancer” – Chest Surg Clin N Am. 1994 Feb;4(1):113-26 – Allen KB, Faber LP, Warren WH.  Here is an excerpt: “Abstract – Diffuse malignant pleural mesothelioma is an uncommon, uniformly fatal malignancy. Controversy continues to surround the optimal surgical procedure, both extrapleural pneumonectomy or pleurectomy, which should be utilized in conjunction with post-operative chemotherapy and/or radiotherapy. This retrospective study reviews a single institution’s experience with extrapleural pneumonectomy and pleurectomy in the multimodality treatment of diffuse malignant pleural mesothelioma.

Another interesting study is called, “Phase II trial of mitomycin in malignant mesothelioma.” By Bajorin, D, Kelsen, D, Mintzer, DM – CANCER TREAT. REP. Vol. 71, no. 9, pp. 857-858. 1987.  Here is an excerpt: “Malignant mesothelioma is a highly lethal neoplasm. Recent data noted in vivo antineoplastic effects of a combination of mitomycin and cisplatin (DDP) greater than either agent alone in human tumor xenograft mesothelioma. While DDP singly has some efficacy, mitomycin has not been systematically evaluated in this disease. A phase II trial was therefore conducted to determine the activity of mitomycin in malignant mesothelioma. Pulmonary toxicity was substantial. Two responding patients developed dyspnea and hypoxemia occurring at cumulative doses of 40 and 50 mg/m super(2), respectively. One patient had a transbronchial biopsy consistent with drug-induced pulmonary fibrosis and never achieved resolution of hypoxemia with corticosteroid therapy prior to death from progressive mesothelioma. The second patient responded to corticosteroid therapy with resolution of dyspnea and hypoxemia but relapsed after discontinuing mitomycin.”

Another interesting study is called, “Immunohistological staining of reactive mesothelium, mesothelioma, and lung carcinoma with a panel of monoclonal antibodies.” – J Clin Pathol 1987;40:19-25 by A K Ghosh, K C Gatter, M S Dunnill, D Y Mason.  Here is an excerpt: “Abstract – A panel of seven monoclonal antiepithelial antibodies of different specificities, including anticytokeratin, human milk fat globule membrane, C, and carcinoembryonic antigen (CEA) were used with the alkaline phosphatase-antialkaline phosphatase (APAAP) immunostaining technique to determine their value in the differentiation between benign and malignant mesothelial cells and lung carcinoma in histological preparations. The anticytokeratin antibody reacted strongly with all cases of reactive mesothelium, mesothelioma, and lung carcinoma. Antibodies to human milk fat globule membrane and the Ca antigen stained mesothelioma and carcinoma and 43% of cases of reactive mesothelium. Staining for carcinoembryonic antigen was not detected in reactive mesothelium or mesothelioma, but was present in most of the lung carcinomas. CEA seemed to be the single most useful marker in distinguishing carcinoma from mesothelioma in that a positive reaction for CEA would indicate carcinoma rather than mesothelioma.”

Another interesting study is called, “Podoplanin as a marker for Mesothelioma” by Noriko Kimura, Itaru Kimura – Pathology International – Volume 55, Issue 2, pages 83–86, February 2005.  Here is an excerpt: “Podoplanin is a specific marker for lymph vessel endothelial cells. It was noted that podoplanin is expressed in reactive mesothelial cells. The utility of podoplanin for the histological diagnosis of tumors was then investigated, especially for mesothelioma. Immunohistochemical study of podoplanin was carried out in five malignant mesotheliomas and 118 other tumors including 93 adenocarcinomas, four squamous cell carcinomas, six gastrointestinal stromal tumors and five endocrine tumors. Immunoreactivity for podoplanin was demonstrated on the cell membrane of tumor cells for all mesotheliomas. All other tumors were negative for podoplanin. Among the many antibodies used for differential diagnosis of malignant mesothelioma, podoplanin has the potential to be an excellent tumor marker in both specificity and sensitivity. The utility of podoplanin as a marker for mesothelioma will be confirmed by further studies.”

We all owe a debt of gratitude to these fine researchers.  If you found any of these excerpts interesting, please read the studies in their entirety.

Monty Wrobleski is the author of this article.  For more information please click on the following links

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