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Alina Miranda

Phone: (+61 8) 9346 2186
Fax: (+61 8) 9346 2816


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Alina Miranda CV
[doc, 40.73 kb]
Updated 07 Sep 2009

Alina Miranda

Thesis

MUC1 in the diagnosis and pathogenesis of malignant mesothelioma.

Summary

Malignant mesothelioma (MM) is a highly aggressive malignancy involving the serosal surfaces of the body mainly the pleural, peritoneal and occasionally pericardial cavities. The incidence of MM has increased over the past 40 years as a result of occupational and environmental exposure to asbestos. The mean latency period between asbestos exposure and tumour development is 25 years, but cases have been reported more than 40 years after exposure. The disease is uniformly fatal with a median survival of around 12 months from initial diagnosis even with the best available active treatment.

Establishing an initial diagnosis of MM can be extremely difficult with patients often presenting with advanced disease. MM is more common in men because of their greater exposure to asbestos. The most common clinical presentation of patients with pleural MM is continuous chest pain due to infiltration of the chest wall, dyspnoea due to pleural effusion, cough, weight loss and malaise.

Treatment options vary, patients presenting with early stage disease may undergo aggressive multimodality therapy which includes extra-pleural pneumonectomy combined with radiotherapy and chemotherapy. For patients with advanced unresectable disease, the most common clinical practice is to use cisplatin and pemetrexed. Palliative therapy with radiotherapy and chemotherapy including cisplatin, can give both symptomatic benefit and prolong survival, approaching meaningful 5 year survival rates in most patients with advanced disease however there is still no cure. So if we could diagnose MM earlier, you would think that patients would respond to treatment better but this has not been proven. Secondly there needs to be better treatment for this disease as current treatments may extend a patients quality of life however, there is no known cure. There are a number of tumour oncoproteins currently under investigation as an appropriate immunotherapeutic target and MUC 1 is a potential tumour oncoprotein which is currently in clinical trials as a possible therapeutic target in breast, prostate and lung cancer.

Why my research is important

Malignant mesothelioma (MM) is a highly aggressive malignancy involving the serosal surfaces of the body mainly the pleural, peritoneal and occasionally pericardial cavities. The incidence of MM has increased over the past 40 years as a result of occupational and environmental exposure to asbestos. The mean latency period between asbestos exposure and tumour development is 25 years, but cases have been reported more than 40 years after exposure. The disease is uniformly fatal with a median survival of around 12 months from initial diagnosis even with the best available active treatment.

Establishing an initial diagnosis of MM can be extremely difficult with patients often presenting with advanced disease. MM is more common in men because of their greater exposure to asbestos. The most common clinical presentation of patients with pleural MM is continuous chest pain due to infiltration of the chest wall, dyspnoea due to pleural effusion, cough, weight loss and malaise.

Treatment options vary, patients presenting with early stage disease may undergo aggressive multimodality therapy which includes extra-pleural pneumonectomy combined with radiotherapy and chemotherapy. For patients with advanced unresectable disease, the most common clinical practice is to use cisplatin and pemetrexed. Palliative therapy with radiotherapy and chemotherapy including cisplatin, can give both symptomatic benefit and prolong survival, approaching meaningful 5 year survival rates in most patients with advanced disease however there is still no cure. So if we could diagnose MM earlier, you would think that patients would respond to treatment better but this has not been proven. Secondly there needs to be better treatment for this disease as current treatments may extend a patients quality of life however, there is no known cure. There are a number of tumour oncoproteins currently under investigation as an appropriate immunotherapeutic target and MUC 1 is a potential tumour oncoprotein which is currently in clinical trials as a possible therapeutic target in breast, prostate and lung cancer.

Funding

  • PathWest adhoc scholarship
  • Dr J Creaney top up scholarship