09:30 - 12:30, 3 hours, International Conference Hall
Plenary Session 4
Medical Aspects: Surveillance and Treatment of Asbestos-related Diseases
4-B: Diagnosis and Treatment of Asbestos-Related Diseases
Chairs: Bruce Robinsoni [not-confirmed] and Takashi Nakano
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Shigeru Miyata, Takashi Nakano, Aki Murakami, Sei-ichi Nobuyama, Taku Okukubo, Shin-ichiro Iida, Kozo Kuribayashi, Mitsutomi Miyake, Hitoshi Nakamura
Department of Internal Medicine, Division of Respiratory Disease, Hyogo College of Medicine, Japan
ABSTRACT:
The incidence of malignant mesothelioma (MM) is rising along with the increasing use of asbestos epidemiologically. MM is a highly lethal and particularly refractory tumor. Several phase II and III studies against MM have been performed over the past 2 decades to demonstrate response rates of 0 to 48 %, with median survivals of only 7-15 months. Irinotecan (CPT-11) is a potent Topoisomerase 1 inhibitor and has a definite cytotoxic activity against mesothelioma in the preclinical studies. Intravenous administration of CPT-11 can produce adequate distribution of CPT-11 and the more active metabolite SN-38 into the pleural fluid and allows SN-38 to come into contact with mesothelioma cells in the thoracic cavity. CPT-11 (125mg/mQ) seems to have minimal single-agent activity in patients with MM, however it has a response rate of 26% (CPT-11:60mg/mQ) and 24% (50mg/mQ) in doublet combinations with cisplatin (CDDP), and 41% (100mg/mQ) in triplet with CDDP+Mitomycin C. However, high dose CPT-11 (190-200mg/mQ) has no activity with docetaxel, and 14.2% with gemcitabine. CPT-11 is clearly a useful agent against MM, and is worthy of further study in combination with other drugs. CPT-11-based treatments for@the patients with MM will be discussed.