The pleural mesothelioma (MM ) is the primary tumor of the pleura due
primarily tied to ' exposure to asbestos fibers that still shows
steadily fatal clinical evolution (12-18 months) with poor response to
conventional therapy .This
worrisome clinical picture is further compounded by ' scientific
evidence of a true " European epidemic " of this cancer that will cause
the next 30 years in Europe a quarter of a million deaths only among
male patients previously exposed ( Peto et al . , 1999)Unfortunately,
the long latency of this pre-clinical cancer (up to 50 years!) And the
consideration that the current exposure is all 'simply does not exist ,
represent a sufficient clue able to portend that the epidemiological
data cited are unfortunately incomplete.In Italy, more than a thousand people a year die from MM . All
' high concentration of mortality in the north of the country you are
adding other areas where deaths from this cancer are alarming increase .
Not
only Bari , Syracuse Manfredonia where they operated industrial
facilities that have used asbestos, but also Pallet Town , in the
province of Catania, where the show was purely environmental .In
Casale Monferrato the existence of a large plant for the production of
articles of asbestos has determined the appearance of a progressive
increase in mortality for MM who has achieved a ' rate of 40 times that
of the rest of Piedmont and which is , unfortunately, still increasing .In
the same area has also seen an ' extension of mortality not only to the
families of former employees ( exposed as a result of suits brought
home dirty ) but the general population exposed to pollution from
previous and fibers , to be evaluated , the residue.
In
addition, a whole series of previously unrecognized work activities are
proving to be at risk for exposure to asbestos with the progressive
increase of mortality from MM .A source of this dramatic picture scenario, for many years the biomedical research on cancer from asbestos has laggedFortunately,
over the past five years, research has taken a definite direction that
is significantly improving the prospects in the fight against these
cancers1 ) Identification of targets on biomolecular methods .
This
set of studies and ' aimed at ' identification and validation of
biomarkers and therapeutic targets molecular ( biochemical signals and
individual proteins , etc. ) into the cells of pleural mesothelioma and
to their use in experimental treatment protocols . Aluni
of these biomarkers have already been identified for both the early
diagnosis and as therapeutic targets and now need further tests both in
the laboratory and in exposed patients , respectively . These
markers were identifiati in alune Italian European and American
University (Novara , Siena , Milan, Pisa DublinTrinity College , Hawaii)
2 ) Genetic studiesa)
The rising global consortium for the study of the genome of human
tumors ( Cancer Genome Atlas) has recently seen the whole place ( thanks
to the pressure of ertain groups Italian ) Mesothelioma among cancers
whose genetic heritage will be studied .The
results of this research will help to identify the genes responsible
for neoplastic transformation and those potentially controllable by
innovatici therapeutic approaches (gene therapy or pharmacological )Qesto
studies will be conducted the Wellcome Sanger Institute in Cambridge
(UK) that will collect samples from mesothelioma worldwide through the
centers forming part of the consortium.3 ) Project for the personalized therapy of mesothelioma plerurico . Personalised Therapya)
At the Wellcome Sanger Institute in Cambridge (UK) will be conducted
according to a draft study of the genetic Mesothelioma goal with the
development of personalized therapies for each patient with pleural
mesothelioma (Head Prof E Campbell ) in collaboration with Prof D. Fennell in Leicester UK . Nature 2012b
) Very recent evidence has shown that sometimes more aggressive genomic
profiles are often positioned in close proximity to less aggressive
profiles within tumor tissue of the same patient . Through
the study of mutations of exomi ( components of the genome) in various
parts of the tumor, it is possible to identify therapeutic strategies
differ according to the genetic response to certain drugs in the light
of the ' heterogeneity of the genetic profile in the same tumor studies
These messages will be conducted by the Prof. C. Swanton
(University of London ), UK has reached an agreement with several
Italian institutes and groups for the inclusion of the tissues of our
patients in the study NEJM March 2012c)
A further proigetto aimed at Personalised therapy will be conducted by
inoculating the tumor on laboratory rats with a new method (defined
tumourgrafts ) with which you can quickly identify the choice of
treatment to be adopted in the patient with cancer whose tumors the mice
were inoculated ( Prof Carbone , HI and Harvey Pass , MD, J Hopkin's University, Baltimore) in a high percentage of casesBut once we have the genetic profile of the disease, however, still do not have the tools for early diagnosis. These
tools can be accessed only with the use of minimally invasive methods
and the analysis of large numbers, with the availability of a cohort
numerically significant (4 / 5,000 patients )To
simplify , we need to explain scientifically how and why mesothelioma
is still a deadly disease , but there are also cases of remission
amazing ( in a patient of Brescia , four years after it disappeared
mesothelioma treatment that other patients do not respond or ripondono less signifiativo ) .
To
date there is still no drug therapy that cures mesothelioma, but we are
close to identifying it, if you convey economic resources together to
achieve a unique resultThe
validation of biomarkers already known and will be revealed that
genomic analysis will be crucial to crown with success of these efforts
led by an international network of integrated centers that include the
flagship European and U.S.This
will lead to new drugs and new therapies for mesothelioma within 2-3
years attarverso conducting clinical sperimementazini at international
level ( Study Phase 1b and Phase II (which I use risulati obtained from
the research program described
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