Living With Mesothelioma _My Diary_ My drug day for MK3475 went very well.


Waking up at 4am to go to The Royal Marsden and hearing the rain beating down was awful.

Ray got soaked just going on a walk with the dog and so did Louis. When the dog got back he came to me and pushed into my legs to make me use the towel on him. I rubbed him dry and he shook off the rain and went back to bed.

We had breakfast and then  set off into the dark and the wet.

Sun rise soon happened and the rain eased when we got to the M25.

We arrived at the Marsden by 8 ok and the nurses were in a meeting so we waited in the waiting room.

Everything is a lot easier on a Tuesday, no rush so when the Sister was telling me this I said if they wanted me to change I would. She jumped at it was so grateful.  As Im in treatment for ever it will mean we can go away at the weekends and get home and do all the washing etc without rushing.

My bloods were taken and I gave a urine sample. The nurse said I had an infection so might need to go on antibiotics.

Another wait for my Doctor.

When I went in to see her I mentioned how my flu jab had given me a reaction. Was it ok that I had it. She said there was no problem. It hadnt shown in my bloods which were all good. They are looking at my urine and will hone me tomorrow if I need antibiotics.

I asked how far can I go talking about my Trial and she replied that as long as I stick to my story I can share with anyone. So thats great as I have to film for Holland on Friday.

She did say the trial was coming to an end and I cant believe that didnt sink in my head. I just said ok.

It wasnt until I was down in the restaurant having a drink that it sunk in to my brain. I said to Ray what happens to me ???

When  we got back and was waiting for my drug to be made I asked the sister.

She explained that the trial will end but as long as I was well and my mesothelioma wasnt growing I remain on the drug. They will always make it for me.Phewww!!!! It seems it would be unethical to just abandon you.

At last the drug came up at 1.15pm and it was put into my veins through my PICC line.

I always give the bag a little stroke and say “go on my wonder drug do your work ”

It was soon finished and I was free to go home. I said goodbye to all the patients and nurses and off we went.

The sun was beaming and the drive home was good. It was a good day.

Wishing good luck to a warrior, who has just been accepted into the Adams Trial at St Barts which is now the TRAP Trial so a reminder

A bioinformatic approach to mesothelioma therapeutics: from ADAM to TRAP


Arginine deprivation is a novel antimetabolite strategy for the treatment of arginine-dependent cancers that exploits differential expression and regulation of key urea cycle enzymes. Several studies have focused on inactivation of argininosuccinate synthetase 1 (ASS1) in a range of malignancies, including melanoma, hepatocellular carcinoma, and mesothelioma. Promoter methylation, in particular, has been identified as a mechanism for loss of the tumor suppressor role of ASS1 leading to tumoral dependence on exogenous arginine. Clinical trials of several arginine depletors are ongoing, including pegylated arginine deiminase (ADI-PEG20, Polaris Group, US) and bioengineered forms of human arginase. The challenge will be to identify tumors sensitive to arginine depletors, and integrate these agents into multimodality drug regimens using predictive biomarkers. Here, we have applied a bioinformatic approach to identify tractable pathways with ADI-PEG20 in the treatment of patients with mesothelioma. Recently, our phase 2 study of ADI-PEG20 in mesothelioma (ADAM) completed accrual and we are now launching a phase I combinatorial trial (TRAP) in the UK based on our bioinformatics studies.


Dr Peter Szlosarek (MBBS BSc MRCP PhD) is a Clinical Senior Lecturer at the Barts Cancer Institute, and Cancer Physician at St. Bartholomew’s Hospital, London. He studied Medicine and Pharmacology at King’s College, London and then specialised in Medical Oncology completing a PhD on the links between TNF-a, inflammation and cancer at the University of London. His clinical and lab research interests are in metabolic approaches to cancer therapy, particularly the role of arginine deprivation therapy in arginine-dependent cancers. This has led to clinical trials of the arginine-depleting agent ADI-PEG20 (Polaris Group, US) in mesothelioma (CTAAC grant) and small cell lung cancer, the latter a collaboration with the Ludwig Institute for Cancer Research in New York, US. He is funded by several grant bodies including Cancer Research UK, Barts and The London Charity, Medical Research Council and the British Lung Foundation. He maintains a research-orientated clinical practice at Barts in thoracic and cutaneous malignancy and is a member of the Royal College of Physicians, the Association of Cancer Physicians, the EORTC, AACR and ASCO.

The Command trial is doing well all through the world

The COMMAND Study is a clinical trial (a type of medical research study) for an oral investigational drug known as defactinib. The trial sponsor, the company Verastem, wants to find out if treatment with defactinib can help people with malignant pleural mesothelioma maintain control of their disease resulting from their first-line therapy of ALIMTA ® (pemetrexed) + cisplatin or carboplatin (platinum).

We believe that defactinib targets cancer stem cells. Cancer stem cells may cause tumor growth. The COMMAND Study will help find out whether defactinib could be a safe and effective approach for treating malignant pleural mesothelioma.

Patients who are interested in enrolling in the COMMAND Study may be asked to sign 1 or 2 Informed Consent documents:

  • Signing the first Informed Consent document enables a patient’s doctor to test for a specific biomarker (a protein called merlin) in tissue they already have available.
  • Signing the second document after completion of first-line therapy enrolls the patient in the COMMAND Study.
  • A patient who qualifies for the study will be given defactinib or a “placebo” and take 2 pills twice a day. A placebo pill looks like real medicine, but it is not. It is a pretend medicine. For the research to be effective, it is important that participants and their doctors don’t know if they are getting the drug or the placebo. This is one of the best ways to determine what defactinib does in patients with malignant pleural mesothelioma.Participants will be assigned randomly (completely by chance) to either the defactinib group or the placebo group. All study-related care (the study medication, diagnostic procedures, laboratory work, physical examinations, blood tests, etc) will be at no additional cost.An estimated 350 to 400 patients will participate in this study at centers in many countries worldwide.Patients may be eligible for the COMMAND Study if they have malignant pleural mesothelioma and meet certain requirements, including:
    • They are currently receiving or have recently completed chemotherapy consisting of at least 4 cycles of ALIMTA ®(pemetrexed) + cisplatin or carboplatin (platinum)
    • They have received pemetrexed + platinum as the first chemotherapy for malignant pleural mesothelioma
    • They have stable disease or better following treatment with pemetrexed + platinum

Picture click on the link then click on the map to find a trial please.

Rays Blog


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