Mesothelioma Clinical Trials - How can I participate in o
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I think a common question that our viewers would have is, what do I need to do to participate in a clinical trial?

Right, so, my point of view is that a very strict every trial has a very strict, very narrow window through which you can squeeze in. So I think the first thing you need to do is A: the type of mesothelioma you have. Cellular type, is that epithelial, is that mixed, is that chromatoid? Those are the number one information patient needs to know. Just saying I have mesothelioma but they really can't tell what the diagnosis is, no, shouldn't be in a trial. You gotta have the diagnosis. That's number one. And that maybe require surgery. That may require evasive procedures which they can tell you before. So that's number one.
Number two is patients needs to be aware that there's no other treatment options. If the patient has been in a trial usually that does not prevent the patient to go into surgery Multi-Modality Therapy. We still take those patients, but if you're gonna go in a trial usually they don't want you to have the Multi-Modality Therapy. They want it out of the equation. So if patients gonna go to the trial they have to know their stage, their type of mesothelioma cell. Stage they are in, the early versus late stage, stage one or two early, stage three or four late. But most importantly we need to see the patients. If they can't tolerate surgery Multi-Modality and a lot of times they can't. And then the trial, it's different.

[inaudible 00:02:02] Are you making progress with sarcomatoid?

That's a very good question. In a patient, my very first patient here in Chicago was sarcomatoid mesothelioma, which again he has two biopsies in an outside hospital. First a needle biopsy, then a core biopsy, then a VATS biopsy. They were all negative, they couldn't tell the correct tissue, blah blah blah. He came to me and said "I will not take no for an answer, [two lives 00:02:34] on the line." We have to do an open biopsy, I'm sorry to tell you that, we gotta go to the OR, gotta have surgery, but I'm not taking that for an answer. Looks like meso, smells like meso, [runs 00:02:45] like meso, has all the colors of meso, you have meso til proven otherwise and it was sarcomatoid. And it was high grade sarcomatoid and that's why it's so hard to treat sarcomatoid mesothelioma, because most of the cells they are so massive that they will not even eat the CarboTaxol.
So we did surgery and now he's gonna get radiation therapy, so the progress again is aggressive surgery sarcomatoid if you can all the way in. For chemotherapy we do have interestingly enough, we do have here, which I'm part of it, and we're just actually named a co-director sarcomatoid clinic that we see Thursday afternoon.

Wow.

So, right, I guess, anyways, they heard I do sarcomatoid surgery, they want me to be part of that. But, and I go to their clinic meetings, again, a lot of different meetings from Baltimore to LA and it's kind of disheartening to see that they really are against the wall, they don't have a lot of chemotherapy options. They do have some, and the way we play this they give chemotherapy two rounds, if they see regression, I try to end. This regression they don't step back, and they try to figure out what's going on. But to answer your question, Natalie, there really isn't at this [court 00:04:03] something there jump, say whoa, wow, it's a miracle drug. There isn't.

Oh boy. Now what about those the new drugs, the new biologics? Are you having?

Well, yeah, so those are trials, that's going to take awhile to really pan out. I think the work that Raphael Bueno is doing at Brigham is, it's leading the ground, he's breaking ground, it's a few years from now, but I have to tell you that it's closest it's ever going to get to determine genetic material mutations, what we call epigenetics. Someone said how about, how much asbestos do I have to have to get mesothelioma, that's called an epigenetic factor, something that changed the DNA after you were born, like a grown-up person, and no one's doing more work on that then Raphael Bueno. But he still five or six years away from actually getting someplace. So when I learn about that, and I, he and I talked about that several times, actually the last three months for other reasons that we have been in contact, he and I said, "you know, Raphael, I think you still, that's great, it's the right direction, but we're still not there yet." And he said "yeah, we're probably five to six years out before we come up with something that will make a difference in the mesothelioma world." But we made, there is progress though. [crosstalk 00:05:26] There's a lot of progress.

Yeah, I think that's the message you getting it out.

Right, so there's a couple [inaudible 00:05:32] learn our patient and I learn that and people laugh at me when I say this, but one is you gotta stay positive, you gotta think positive, you have to understand that it's [old 00:05:41] and you have to understand that it's very intelligent, capable, doctors all across the country.[Magfone college 00:05:49] Radiation college, surgeon, they are passionate for what they do, they all are, if you get in a table, they all want more chemo, all more radiation, more surgery because we're passionate for what we do. And there's a lot of people involved with that. I was at [AECS 00:06:02] in Toronto, and the group in Toronto are very strong with radiation [inaudible 00:06:06] two weeks later in surgery, they're, I'm going to adopt the protocol as well. So these people really looking to this, another friend of mine from London, I should go visit him soon, he's got a different protocol with iodine, of all the things, iodine is [scrub in the chest 00:06:22] and he's got great results so I'm thinking oh my golly this is, this is fantastic. People really going at it and at some point we're going to find the answer for this.

Yeah, I think you will.

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