At long last, plans are moving forward to establish a national mesothelioma patient registry in the United States. A key meeting of experts planning the registry will be held on Tuesday March 26, 2019  in Bethesda. The meeting will include panel presentations by mesothelioma experts from CDC and NIOSH, and will include a substantial opportunity for stakeholders to provide to suggestions and comments.  The long hoped for registry is moving into place after years of efforts to obtain funding to to put a national registry in place, which already has been done for other rare diseases. The funding and registry are coming to fruition because of the tireless efforts of the Mesothelioma Applied Research Foundation, mesothelioma patients, and a wide range of advocates for those patients.

For the specifics about the meeting, including links to register, please see our February 19, 2019 blog post at the ToxicoGenomica blog.

A newly published study provides new asbestos data from Italy as to apparent sources of mesotheliomas.  Note especially the data regarding apparent non-occupational sources of disease.

Introduction Italy produced and imported a large amount of raw asbestos, up to the ban in 1992, with a peak in the period between 1976 and 1980 at about 160 000 tons/year. The National Register of Mesotheliomas (ReNaM, “Registro Nazionale dei Mesoteliomi” in Italian), a surveillance system of mesothelioma incidence, has been active since 2002, operating through a regional structure.

Methods The Operating Regional Center (COR) actively researches cases and defines asbestos exposure on the basis of national guidelines. Diagnostic, demographic and exposure characteristics of non-occupationally exposed cases are analysed and described with respect to occupationally exposed cases.

Results Standardised incidence rates for pleural mesothelioma in 2008 were 3.84 (per 100 000) for men and 1.45 for women, respectively. Among the 15 845 mesothelioma cases registered between 1993 and 2008, exposure to asbestos fibres was investigated for 12 065 individuals (76.1%), identifying 530 (4.4%) with familial exposure (they lived with an occupationally exposed cohabitant), 514 (4.3%) with environmental exposure to asbestos (they lived near sources of asbestos pollution and were never occupationally exposed) and 188 (1.6%) exposed through hobby-related or other leisure activities. Clusters of cases due to environmental exposure are mainly related to the presence of asbestos-cement industry plants (Casale Monferrato, Broni, Bari), to shipbuilding and repair activities (Monfalcone, Trieste, La Spezia, Genova) and soil contamination (Biancavilla in Sicily).

Conclusions Asbestos pollution outside the workplace contributes significantly to the burden of asbestos-related diseases, suggesting the need to prevent exposures and to discuss how to deal with compensation rights for malignant mesothelioma cases induced by non-occupational exposure to asbestos.”

Malignant mesothelioma due to non-occupational asbestos exposure from the Italian national surveillance system (ReNaM): epidemiology and public health issues, Occup Environ Med doi:10.1136/oemed-2014-102297.

The abstract below is online here.
Journal of Clinical Oncology, 2015 ASCO Annual Meeting (May 29 – June 2, 2015).
Vol 33, No 15_suppl (May 20 Supplement), 2015: e18544
© 2015 American Society of Clinical Oncology

Mesothelioma in the United States: A Surveillance, Epidemiology and End Results (SEER)-Medicare investigation of treatment patterns and survival.

Jennifer Lynn Beebe-Dimmer, Cecilia Yee, Tapashi Dalvi, Jon Fryzek, David Garabrant, Ann G. Schwartz and Shirish M. Gadgeel

Karmanos Cancer Inst Onc Wayne State School of Medcn, Detroit, MI; Karmanos Cancer Institute Division of Population Studies and Disparities Research, Detroit, MI; MedImmune, LLC, Gaithersburg, MD; EpidStat Inc, Ann Arbor, MI; EpidStat Inc., Ann Arbor, MI; Karmanos Cancer Institute, Wayne State University, Detroit, MI; Karmanos Cancer Inst/Wayne State Univ, Detroit, MI

Abstract Disclosures



Background: Mesothelioma is a rare malignancy typically associated with exposure to asbestos and poor survival. The purpose of this investigation was to describe mesothelioma patient characteristics, treatment patterns and survival, both overall and according to treatment course utilizing the National Cancer Institute’s SEER-Medicare database.Methods: Patients in this study were diagnosed with malignant mesothelioma of the pleura, peritoneum or other site between 01/01/2005 and 12/31/2009 with follow-up for survival through 12/31/2010. We determined the distribution of patient and tumor characteristics at time of diagnosis, and subsequent treatment patterns (surgery, radiation and chemotherapy). Among patients treated with chemotherapy, we determined chemotherapy regimen and estimated survival by line of therapy. Results: Of the 1,625 patients considered eligible for this investigation, the median age at time of diagnosis was 78 years (age range; 66 to 103 years) and 78% were male. 30% of these patients had surgery and 45% were given chemotherapy. The median overall survival was 8 months (mos) (range 1-69 mos). The median survival of patients treated with surgery and chemotherapy (n = 249) was 14 mos and 5 mos among patients who received surgery but no chemotherapy (n = 237). Among non-surgical patients, the median survival among patients who received chemotherapy (n = 478) was 10 mos and patients who did not was 4 mos (n = 623). Among chemotherapy patients, the most commonly (68%) prescribed regimen for first line therapy was Cisplatin or Carboplatin (Ca/Ci) combined with Pemetrexed (Pe). Among those prescribed a second line therapy, retreatment with Ca/Ci + Pe was the most common treatment (33%).Conclusions: Mesothelioma patients receiving chemotherapy survive longer than patients who did not. The observational nature of this study makes it difficult to attribute differences in survival to regimen alone and may be explained by other patient-related factors.