Mesothelioma Treatment & Research Progress Report: Center ... · The University of Maryland School...

The University of Maryland School of Medicine

Mesothelioma Treatment & Research Center

Progress Report: 2015 – 2018Joseph S. Friedberg, MD Director

MISSION STATEMENTThe University of Maryland School of Medicine Mesothelioma Treatment and

Research Center is dedicated to being the world’s foremost center for the treatment and study of mesothelioma.

The Center brings to bear all of the extraordinary medical and scientific resources available at the University of Maryland, as well as collaborating with likeminded

researchers across the globe, and is dedicated to providing the best treatments available today and developing the best treatments available tomorrow.

T h e U n i v e r s i t y O f M a r y l a n d S c h o o l O f M e d i c i n e

M e s o t h e l i o m a Tr e a t m e n t & R e s e a r c h C e n t e r

Joseph S. Friedberg, MD, FACS

Charles Reid Edwards Professor of Surgery, University of Maryland School of MedicineThoracic Surgeon-in-Chief, University of Maryland Medical System

Director, University of Maryland School of Medicine Mesothelioma and Thoracic Oncology Center

P r o g r e s s R e p o r t

M E S O T H E L I O M A T R E A T M E N T & R E S E A R C H C E N T E R

Shamus Carr, MD Assistant Professor of Surgery

Charles Simone, II, MD Associate Professor of Radiation Oncology

Richard Eckert, MD Discovery-Translational Research

Kenneth Miller, MD Assistant Professor of Medicine

T h o r a c i c S u r g e r y

M e d i c a l O n c o l o g y / P a t h o l o g y

R a d i a t i o n O n c o l o g y / R a d i o l o g y

C o l l a b o r a t i v e M e s o t h e l i o m a T e a m

Joseph Friedberg, MD Professor of Surgery

Erica Glass, CRNP Nurse Practitioner, Radiation Oncology

Ashutosh Sachdeva, MD Interventional Pulmonology

Katherine Scilla, MD Assistant Professor of Medicine

Melissa Culligan, RN, MS Clinical Instructor in Surgery

Jean Jeudy, MD Associate Professor of Radiology

Melissa McDiarmid, MD Occupational Medicine

Petr Hausner, MD Assistant Professor of Medicine

Shelby Stewart, MD Assistant Professor of Surgery

Pranshu Mohindra, MD Assistant Professor of Radiation Oncology

Edward Pickering, MD Interventional Pulmonology

Christian Rolfo, MD Professor of Medicine

Colleen Norton, RN, BSN Mesothelioma Nurse Navigator

Charles White, MD Professor of Radiology

Tamara Khashab, MD Clinical Research

Allen Burke, MD Associate Professor of Pathology

Jonathan Heath, MD Assistant Professor of Pathology

Meet the Mesothelioma Team

Not Pictured

2 T H E U N I V E R S I T Y O F M A R Y L A N D S C H O O L O F M E D I C I N E

Clinical Services

The sole focus of The Center is what is best for the patient, with the

providers being defined by dedication, compassion, teamwork and the

esprit de corps that comes from being part of a program that offers

hope for one of the most challenging problems in medicine. The clinical

arm of The Center focuses on providing the patient with all appropriate state of the

art treatment options, including clinical trials. The process starts with any form of

contact to The Center by the patient, a family member or

a referring physician. Within hours the patient can expect

a call from The Center’s Mesothelioma Nurse Navigator.

The Navigator interviews the patient, gathers all necessary

records and puts together a presentation for The Center’s

weekly multidisciplinary conference where all potential

treatment options are considered and discussed. The

patients and their families are then seen immediately after

the conference, staying in the same exam room with all

relevant specialists rotating through to consult with them.

The consultations only conclude when all questions are

answered and the patient has the necessary information to

decide how they would like to proceed. As the majority of

patients come from afar, every effort is made to integrate

the patient’s local physicians into the treatment team. The

weekly conference is attended by specialists in: thoracic

surgery, oncology nursing, integrative medicine, pathology,

chest radiology, pulmonary medicine, medical oncology

and radiation oncology. Also affiliated with The Center are: discovery scientists,

translational researchers, immunologists, clinical researchers, occupational medicine

specialists, epidemiologists, nutritionists, physical therapists, respiratory therapists,

palliative care specialists, social workers, clergy and psychiatrists. The breadth and

depth of integrated expertise embodied within the University of Maryland School of

Medicine Mesothelioma Treatment and Research Center is unique and unsurpassed.

Weekly Multidisciplinary Patient Conference

M E S O T H E L I O M A T R E A T M E N T & R E S E A R C H C E N T E R 3


Radiation Oncology Team FROM LEFT: Stephanie Rice, MD; Charles Simone, MD; Erica Glass, CRNP

Medical Oncology Team FROM LEFT: Petr Hausner, MD; Katherine Scilla, MD; Kenneth Miller, MD; Christian Rolfo, MD

Mesothelioma Patient Conference

FROM LEFT: Colleen Norton, BSN; Charles Simone, MD; Kenneth Miller, MD; Edward Pickering, MD

Pathology and Radiology Team Members FROM LEFT: Jonathan Heath, MD and Jean Jeudy, MD

Interventional Pulmonary Medicine Team FROM LEFT: Blaine Kenaa, MD; Peter Olivieri, MD; Edward Pickering, MD; Ashutosh Sachdeva, MD; Matthew Paparo, MD


Research

Although The Center has not even been in existence for three years, the

foundation for a robust research program has already been established.

All initial efforts were placed into building the clinical program, which is

now internationally recognized, and the research program is now poised

to explode. The research program has been designed to blend seamlessly with the

clinical program, one of very few such double-armed mesothelioma programs in the

world. Especially for a rare cancer like mesothelioma, this is a formula where “the whole

is greater than the sum of the parts,” with both the research

and clinical efforts benefiting from association with the

other. The research that is in development spans the entire

spectrum of needs for mesothelioma patients, ranging from:

discovery science through clinical trials, prevention through

palliation and investigator initiated in-house trials through

international multi-institution collaborative trials. A full list of

the current research projects can be found in Appendix 1, but

briefly, the projects are as follows:

Discovery Science – This effort focuses on the basic

science of mesothelioma and contributes to the general

understanding of this cancer and identification of

treatment opportunities at the cellular level.

Translational Research – This effort is geared toward

developing treatments for mesothelioma patients

anticipated to go from “bench to bedside” within three

to seven years. Some of these projects will be developed

as offshoots of promising findings from the discovery science effort.

Screening and Early Detection – The Center has teamed up with the internationally

acclaimed Occupational Medicine Department at the University of Maryland.

Together we are in the process of developing both the first mesothelioma registry,

which is poised to become the first national registry for this cancer, and a very

sophisticated screening questionnaire. The latter, in combination with liquid biopsy

technology we are exploring, has potential to emerge as the first screening program

for mesothelioma.

Dr. Richard Eckert in his mesothelioma research laboratory



Prevention – One of the ongoing discovery science projects has provided compelling

evidence that a certain natural dietary supplement might be effective in short circuiting

the pathway that leads from asbestos exposure to mesothelioma. This is a potentially

revolutionary discovery that would provide the first course of action available for

patients at risk for developing mesothelioma and who will be readily identified through

our new Mesothelioma Screening and Early Detection Program. There is preliminary

data to suggest that this natural supplement may not just serve as a prophylaxis

against developing mesothelioma, but may also emerge as an effective treatment for

established mesothelioma.

Clinical Trials for All Presentations of Mesothelioma – This is the core strength of

The Center and the portfolio of clinical trials for this cancer has been in development

since The Center’s inception. We are about to start rolling out these trials, which

historically leads to a significant influx of patients for this particular cancer. The trials

will include, either alone or in combination, the modalities of: surgery, proton therapy,

chemotherapy, immunotherapy, dendritic cell therapy, tumor vaccine therapy, gene

therapy, electromagnetic field therapy and photodynamic therapy. It is anticipated

that, within five years, no other program will have an equally comprehensive offering of

clinical trials.

Integrative Medicine – Recognizing that a diagnosis of mesothelioma affects more than

just the lining of the chest cavity, The Center is committed to embracing an integrated

holistic approach for our patients. Trials to evaluate and optimize the modalities of

mindfulness, acupuncture, diet, massage and Reiki are under development.


The Center was established less than three years ago

and has consulted upon patients from across the

country and internationally (Appendix 2). Members

of the Center have published their research in peer-reviewed

journals (Appendix 3), are invited speakers and presenters

at national and international mesothelioma meetings

(Appendix 4) and serve on national and international

mesothelioma and thoracic oncology committees (Appendix

5). As part of the Center’s marketing plan, Drs. Friedberg and

Simone participated in a Facebook Live event that was well

received by the mesothelioma community (Appendix 6).

2018 UPDATE



Research Project Collaborative Team Status Funding Target

Sulforaphane, TG2, YAP1 and Mnk1/elF4E as novel targets for mesothelioma

Thoracic Surgery, Dr. Richard Eckert

Projects ongoing with shared NIH T-32 post-doctoral trainee

RO-1 –{2019}

Photobrachytherapy*Friedberg Holds Patent

Thoracic Surgery, UPENN

Conceptual work complete; research team assembled

RO-1 {2020}

FN-14 targeted therapies for mesothelioma Thoracic Surgery, Neurosurgery (UM)

Conceptual work complete; research team assembled

RO-1 {2018/19}

Inhaled lung sealant*Friedberg Holds Patent

Thoracic Surgery, Hopkins Conceptual work complete; research team assembled

SBIR {2019}

Identification of airleaks Thoracic Surgery Protocol in development R-21 {2019}

Mesothelioma Patient Registry / Screening Pilot

Thoracic Surgery, Medical & Radiation Oncology, Occupational Medicine

Protocol written and start date for pilot study is September 2018

CDC Funding Meso Registry Bill$500,000.00 {2020}

WINNERS Trial Improving care of thoracic surgery patients

Protocol in development with target start date, pending funding

PCORI Grant {2019}

Phase I/II Trial of Whole Pleural Intensity-Modulated Proton Therapy (IMPT) & Concurrent Chemotherapy for Patients with MPM

Medical Oncology, Radiation Oncology

Multicenter

Protocol in development Industry Sponsorship

Dual Agent Immunotherapy with a CXCR2 Inhibitor in Patients with Mesothelioma and Sarcoma


Protocol in developmentProposal submitted to Novartis

Industry Sponsorship

Combining Immunotherapy with Nivolumab & IDO inhibitors in Patients with Mesothelioma


Proposal submitted to Merck Industry Sponsorship

Phase III Study to Evaluate the Efficacy & Safety of Intrapleural Administration of Adenovirus-Delivered Interferon Alpha-2b (rAd-IFN) in Combination with Celecoxib & Gemcitabine in Patients with MPM

UPENN, New York University TRIZELL contract in review Industry Sponsorship

National Mesothelioma Virtual Bank (NMVB) Thoracic Surgery; Pathology (Burke); Eckert

NIH Funded – Subcontract$100,000/year for 5 years

ACTIVE

Prospective Molecular Analysis Study Thoracic Surgery, Pathology, Harvard

RO1 Subcontract $50,000/year for 5 years

ACTIVE

Randomized Phase II Trial of Radical Pleurectomy and Post-operative Chemotherapy with or without Photodynamic Therapy for Patients with MPM

UPENN, French Mesothelioma Consortium

Ongoing NIH PO1

UM Budget pending

ACTIVE

APPENDIX 1

UMSOM - MESOTHELIOMA RESEARCH PROGRAM DEVELOPMENT

APPENDIX 2

MESOTHELIOMA CENTER CLINICAL GROWTH


70

60

50

40

30

20

10

0

Apr - Jun 2015

Apr - Jun 2017

Apr - Jun 2016

Oct - Dec 2015

Oct - Dec 2017

Jul - Sep 2015

Jul - Sep 2017

Jul - Sep 2016

Jan - Mar 2015

Jan - Mar 2017

Jan - Mar 2016

Oct - Dec 2016

Mesothelioma Patients Reviewed in Tumor Boards – Pleural and Peritoneal

Pleural Peritoneal Dual Compartment

Apr - Jun 2018

Jan - Mar 2018

80

70

60

50

40

30

20

10

0

International Referrals: Canada – 1 Turkey – 2

University of Maryland New Mesothelioma Referrals by States February 2015 – June 2018 – Pleural/Peritoneal

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Virg

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Illio

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New

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Flor

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New

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Mic

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Alab

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Geor

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Penn

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Calif

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Nebr

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Mar

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30

25

20

15

10

5

0

Apr - Jun 2015

Apr - Jun 2017

Apr - Jun 2016

Oct - Dec 2015

Oct - Dec 2017

Jul - Sep 2015

Jul - Sep 2017

Jul - Sep 2016

Jan - Mar 2015

Jan - Mar 2017

Jan - Mar 2016

Oct - Dec 2016

New Mesothelioma Patients Seen in Clinic – Pleural & Peritoneal

Pleural Peritoneal Dual Compartment

Apr - Jun 2018

Jan - Mar 2018

APPENDIX 3

MESOTHELIOMA RELATED PUBLICATIONS

Peer-Reviewed Manuscripts:

1. Sterman DH, Alley E, Stevenson JP, Friedberg J, Metzger S, Recio A, Moon EK, Haas AR, Vachani A, Katz SI, Sun J, Heitjan DF, Hwang WT, Litzky L, Yearley JH, Tan KS, Papasavvas E, Kennedy P, Montaner L, Cengel KA, Simone CB II, Culligan M, Langer C, Albelda SM. Pilot and feasibility trial evaluating immuno-gene therapy of malignant mesothelioma using intrapleural delivery of adenovirus-IFNa combined with chemotherapy. Clin Cancer Res. 2016;22(15):3791-800.

2. Rusch V, Gill R, Mitchell A, Naidich D, Rice D, Pass H, Kindler H, DeParrot M, Friedberg JS. A Multicenter Study of Volumetric Computed Tomography for Staging Malignant Pleural Mesothelioma. Annals of Thoracic Surgery. 102:1059-66 2016.

3. Friedberg JS, Simone CB II, Culligan MJ, Barsky AR, Doucette A, McNulty S, Hahn SM, Alley E, Sterman DH, Glatstein E, Cengel KA. Extended Pleurectomy-Decortication-Based Treatment for Advanced Stage Epithelial Mesothelioma Yielding a Median Survival of Nearly Three Years. Ann Thorac Surg. 2017;103(3):912-919.

4. Verma V, Ahern CA, Berlind CG, Lindsay WD, Sharma S, Shabason J, Culligan MJ, Grover S, Friedberg JS, Simone CB II. National Cancer Database Report on Pneumonectomy Versus Lung-Sparing Surgery for Malignant Pleural Mesothelioma. J Thorac Oncol. 2017;12(11):1704-1714.

5. Alley EW, Katz SI, Cengel KA, Simone CB II. Immunotherapy and radiation therapy for malignant pleural mesothelioma. Transl Lung Cancer Res. 2017;6(2):212-219.

6. Patel AM, Berger I, Wileyto EP, Khalid U, Torigian DA, Nachiappan AC, Barbosa EM Jr, Gefter WB, Galperin-Aizenberg M, Gupta NK, Simone CB II, Haas AR, Alley EW, Singhal S, Cengel KA, Katz SI. The value of delayed phase enhanced imaging in malignant pleural mesothelioma. J Thorac Dis. 2017;9(8):2344-2349.

7. Berger I, Simone CB II, Haas AR, Alley E, Cengel KA, Friedberg JS, Singhal S, Khalid U, Patel A, Katz SI. Lymphangitic carcinomatosis: a common but underreported manifestation of disease progression in patients with malignant pleural mesothelioma following radical pleurectomy. AJR Am J Roentgenol. 2017; submitted.

8. Friedberg JS, Culligan M, Katz S, Torigian DA, Udupa J, Galperin-Aizenberg M, Putt M, Mick R, Shin M, McKay KM, Albelda SM, Glatstein E, Hahn SM, Cengel KA, Simone CB II. Comparison of radiographic tumor volume estimation techniques for malignant pleural mesothelioma: their correlation with each other, actual measured intraoperative tumor volumes, and overall survival. J Thorac Oncol. 2018; draft manuscript.

9. Barsky AR, Buckley JP, Friedberg JS, Culligan M, Hahn SM, Cengel KA, Simone CB II. Prophylactic irradiation of surgical tract sites in the era of radical pleurectomy for malignant pleural mesothelioma. J Thorac Oncol. 2018; draft manuscript.

10. Barsky AR, Friedberg JS, Culligan M, Sterman DH, Alley E, Litzky LA, Glatstein E, Hahn SM, Cengel KA, Simone CB II. Radiation-induced malignant mesothelioma: frequency and prognosis. J Thorac Oncol. 2018; draft manuscript.

11. Li YR, Alley EW, Friedberg JS, Culligan MJ, Busch TM, Hahn SM, Cengel KA, Simone CB II. Prospective assessment of proton therapy for malignant pleural mesothelioma. Int J Radiat Oncol Biol Phys. 2018; draft manuscript.

12. Verma V, Ahern CA, Berlind CG, Lindsay WD, Grover S, Culligan MJ, Friedberg JS, Simone CB II. Facility Volume and Postoperative Outcomes for Malignant Pleural Mesothelioma: a National Cancer Data Base Analysis. Lung Cancer. 2018; in press.

13. Badiyan SN, Molitoris JK, Zhu M, Glass E, Diwanji T, Simone CB II. Proton Beam Therapy for Malignant Pleural Mesothelioma. Transl Lung Cancer Res. 2018; in press.

14. Verma V, Ahern CA, Berlind CG, Lindsay WD, Shabason J, Sharma S, Culligan MJ, Grover S, Friedberg JS, Simone CB II. Survival by Histologic Subtype of Malignant Pleural Mesothelioma and the Impact of Definitive Surgery on Overall Survival: Analysis of the National Cancer Data Base. Clin Lung Cancer. 2018; submitted.

15. Shaaban SG, Verma V, Choi JI, Shabason J, Sharma S, Glass E, Grover S, Badiyan SN, Simone CB II. Utilization of Intensity-Modulated Radiation Therapy for Malignant Pleural Mesothelioma in the United States Corresponding Author: Vivek Verma. Clin Lung Cancer. 2018; submitted.

16. Cramer G, Simone CB II, Busch TM, Cengel KA. Adjuvant, Neoadjuvant, and Definitive Radiation Therapy for Malignant Pleural Mesothelioma. J Thorac Dis. 2018; submitted.

17. Friedberg JS, Simone CB II, Culligan MJ, Barsky AR, Putt M, Cengel K. Posterior Intercostal Lymph Nodes Impact Overall Survival for Malignant Pleural Mesothelioma. Annals Thoracic Surg. 2018; submitted.

18. Adhikary G, Grun D, Alexander HR, Friedberg JS, Xu W, Keillor JW, Kandasamy S, Eckert RL. Transglutaminase is a Mesothelioma Cancer Stem Cell Survival Protein that is Required for Tumor Formation. Oncotarget 2018; in press.



Presentations/Abstracts:

1. Li YR, Alley EW, Friedberg JS, Culligan M, Busch TM, Hahn SM, Cengel KA, Simone CB II. Prospective Assessment of Proton Therapy for Malignant Pleural Mesothelioma. Accepted, International Association for the Study of Lung Cancer 16th World Conference on Lung Cancer, 2015. [Oral]

2. Cengel KA, Hagan S, Moon E, Simone CB II. Examining the role of growth factor/inflammatory signaling pathway crosstalk in mesothelioma sensitivity to photodynamic therapy and radiation therapy using 2D and novel 3D tissue culture models. Accepted, 13th International Conference of the International Mesothelioma Interest Group (iMig 2016), 2016. [Oral]

3. Berger I, Simone CB II, Hass A, Alley E, Cengel KA, Friedberg J, Khalid U, Patel A, Sharyn Katz. Lymphangitic carcinomatosis is a common but underreported manifestation of disease progression in patients with malignant pleural mesothelioma following radial pleurectomy. Accepted, 13th International Conference of the International Mesothelioma Interest Group (iMig 2016), 2016.

4. Patel A, Berger I, Khalid U, Torigian D, Simone CB II, Hass A, Alley E, Cengel KA, Katz S. The Value of Delayed Enhancement for Magnetic Resonance Imaging of Malignant Pleural Mesothelioma. Accepted, 13th International Conference of the International Mesothelioma Interest Group (iMig 2016), 2016. [Oral]

5. Simone CB II, Li YR, Busch TM, Finlay JC, Kim MM, McNulty S, Dimofte A, Zhu TC, Cengel KA. First Prospective Study Assessing the Combination of Photodynamic Therapy and Proton Radiation Therapy: Safety, Outcomes, and Potential Synergy When Treating Malignant Pleural Mesothelioma. Accepted, SPIE Photonics West 2016, 2016. [Oral]

6. Friedberg JS, Simone CB II, Culligan M, Barsky AR, Alley E, Sterman DH, Cengel KA. An extended-pleurectomy decortication-based treatment for advanced stage, large tumor volume epithelial mesothelioma yielding a median survival of greater than three years. Accepted, The Society of Thoracic Surgeons 52nd Annual Meeting, 2016. [Oral]

7. Cengel KA, Moon EK, Albelda S, Busch T, Simone CB II. Growth factor and inflammatory signaling pathway interactions influence outcomes following multimodality therapy for mesothelioma. Accepted, International Association for the Study of Lung Cancer 17th World Conference on Lung Cancer, 2017.

8. Li YC, Khashab T, Terhune J, Eckert RL, Hanna N, Burke A, Alexander HR. Preoperative thrombocytosis predicts shortened survival of patients with malignant peritoneal mesothelioma undergoing operative cytoreduction and hyperthermic intraperitoneal chemotherapy. Ann Surg Oncol 24: 2259-2265, 2017.

9. Molitoris JK, Glass E, Miller K, Culligan M, Friedberg JS, Simone CB II, Badiyan SN. Toxicities and clinical outcomes of whole pleural intensity-modulated proton therapy for lung-intact malignant pleural mesothelioma. Submitted, American Society for Radiation Oncology 60th Annual Meeting, 2018.

10. Molitoris JK, Glass E, Miller K, Culligan M, Friedberg JS, Badiyan SN, Simone CB II. Toxicities and Clinical Outcomes of Whole Pleural Intensity-Modulated Proton Therapy for Lung-Intact Malignant Pleural Mesothelioma. Accepted, 14th International Conference of the International Mesothelioma Interest Group (iMig 2018), 2018. [Oral]

11. Katz S, Patel A, McNulty S, Berger I, Khalid U, Torigian D, Haas A, Nachiappan A, Simone CB II, Singhal S, Alley E, Cengel KA. Dynamic Enhancement of Malignant Pleural Mesothelioma with Computed Tomography (CT): A Prospective Clinical Trial. Accepted, 14th International Conference of the International Mesothelioma Interest Group (iMig 2018), 2018. [Oral]

12. Friedberg JS, Simone CB II, Culligan MJ, Barsky AR, Putt M, Cengel K. Posterior Intercostal Lymph Nodes Impact Overall Survival for Malignant Pleural Mesothelioma. Submitted, American Association for Thoracic Surgery (AATS) 98th Annual Meeting, 2018.

13. Friedberg JS, Simone CB II, Culligan M, Barsky A, Putt ME, Cengel K. Posterior Intercostal Lymph Nodes, a Previously Undescribed Lymph Node Station, are Highly and Independently Prognostic for Malignant Pleural Mesothelioma. Submitted, The Society of Thoracic Surgeons 54th Annual Meeting, 2018.

14. Adhikary G, Grun G, Varghese S, Alexander-HR, Friedberg JS, Xu-W, Keillor J, Kandasamy S, Eckert RL. Transglutaminase is a mesothelioma cancer stem cell survival protein that is required for tumor formation. Cancer Res (submission planned in 2018)

Book Chapters:

Friedberg JS, Culligan M, Carr S. Results After Intraoperative Therapy in Malignant Pleural Mesothelioma. Bentham Scientific eBook. – in press, 2015.

Culligan M, Friedberg, JS. Caring for Patients Undergoing Pleural Surgery. Caring for Patients with Mesothelioma: Principles and Guidelines. Springer Nature – in press July 2018

Stewart S, Friedberg JS. Pleurectomy for Mesothelioma, Thoracic Surgery 3rd Edition, Churchill-Livingstone, in press 2018.

1 0 T H E U N I V E R S I T Y O F M A R Y L A N D S C H O O L O F M E D I C I N E

APPENDIX 4

NATIONAL /INTERNATIONAL INVITED PRESENTATIONS

M E S O T H E L I O M A T R E A T M E N T & R E S E A R C H C E N T E R 1 1


Joseph S. Friedberg, MD (Thoracic Surgery)

2015

• Surgery as a local therapy for Mesothelioma. International Scientific Symposium on Malignant Mesothelioma, National Cancer Institute, Bethesda, Maryland

• Surgery for Malignant Pleural Mesothelioma. Pulmonary and Critical Care Grand Rounds, University of Maryland Medical Center, Baltimore, Maryland

• Surgery for Malignant Pleural Mesothelioma. Anesthesia Grand Rounds, University of Maryland Medical Center, Baltimore, Maryland

• Surgery for Malignant Pleural Mesothelioma – Mozart or Metallica? Surgery Grand Rounds, University of Maryland Medical Center, Baltimore, Maryland

• Grand Rounds: Difficult Mesothelioma Cases 16th IASLC World Conference on Lung Cancer, Denver, CO

• Surgical Management of Malignant Pleural Mesothelioma. UPDATE: Thoracic Oncology 2015 – University of Maryland School of Medicine CME/CE Program, Baltimore, Maryland, September 2015

2016

• Tips and Pitfalls of Extended Pleurectomy-Decortication for Mesothelioma. Japanese Association for Thoracic Surgery, Annual Meeting. Okayama, Japan

• Surgical Management of Malignant Pleural Mesothelioma. Johns Hopkins University School of Medicine 6th Annual Evaluation and Management of Pleural Disease, Baltimore, Maryland

• Surgery for Malignant Pleural Mesothelioma. Diagnostic Radiology and Nuclear Medicine Grand Rounds, University of Maryland Medical Center, Baltimore, Maryland

• Surgery for Malignant Pleural Mesothelioma. Grand Rounds, Shady Grove Medical Center, Rockville, Maryland

• Surgery for Malignant Pleural Mesothelioma. Grand Rounds, Prince Georges’ Hospital Center, Lanham, Maryland

• Surgery for Malignant Pleural Mesothelioma. Grand Rounds, Holy Cross Hospital, Silver Spring, Maryland

• Presenting Author – “A Novel System for Identifying Pulmonary Air Leaks with an Inhaled Marker” 96th AATS Annual Meeting, Baltimore, Maryland

• Surgical Management of Malignant Pleural Mesothelioma. UPDATE: Thoracic Oncology 2016 – University of Maryland School of Medicine CME/CE Program, Baltimore, Maryland, November 11, 2016

2017

• Lung-Sparing Surgery for Malignant Pleural Mesothelioma. Japanese Association for Thoracic Surgery, Annual Meeting. Tokyo, Japan


• Surgical Management of Malignant Pleural Mesothelioma. UPDATE: Thoracic Oncology 2017 – University of Maryland School of Medicine CME/CE Program, Baltimore, Maryland, November 17, 2017

2018

• Surgery for Malignant Pleural Mesothelioma. 41st Annual Meeting of the Japan Society for Respiratory Endoscopy, Osaka, Japan


• Surgical Management of Malignant Pleural Mesothelioma. American Thoracic Society Annual Meeting, San Diego, CA

• Lung-Sparing Surgery for Malignant Pleural Mesothelioma. Cleveland Clinic Visiting Professor, Cleveland, Ohio

• Lung-Sparing Surgery for Malignant Pleural Mesothelioma. American Society of Clinical Oncology Annual Meeting, Chicago, IL

• Session Chair – Surgical Palliation for Malignant Pleural Mesothelioma. International Mesothelioma Interest Group – 14th International Conference, Ottawa, Canada, May 2018

International Lung-Sparing Surgery for Malignant Pleural Mesothelioma Surgical Mentorship Program – Joseph Friedberg, MD

• 2016: Lung-Sparing Surgery for Malignant Pleural Mesothelioma Demonstration at the University of Maryland Medical Center, Japanese Thoracic Surgery Fellow and Attending Thoracic Surgeon

• 2017: Lung-Sparing Surgery for Malignant Pleural Mesothelioma Demonstration – Lille, France

• 2018: Lung-Sparing Surgery for Malignant Pleural Mesothelioma Visiting Thoracic Surgery Fellowship at the University of Maryland Medical Center – Japanese Thoracic Surgeon


Richard Eckert, MD (Basic and Translational Science)

2017

• A Novel Mesothelioma Cancer Stem Cell Survival Factor and Therapy Target. International Symposium on Malignant Mesothelioma (March 2017)

• Cancer Stem Cell Therapy in Mesothelioma. Research in Progress Seminar with T32 Grant Trainees, Platform Presentation, University of Maryland School of Medicine (October 16, 2017)

• A Mesothelioma Cancer Stem Cell Survival Factor and Therapy Target, Mesothelioma Cancer Center Retreat, University of Maryland School of Medicine, Platform Presentation (October 5, 2017)

2018

• Verteporfin and Sulforaphane Suppress Mesothelioma Cancer Stem Cell Survival”, 7th Annual Biochemistry and Molecular Biology Retreat, University of Maryland School of Medicine, Poster Presentation (January 19, 2018)

• Successful Collaboration between Surgeons and Basic Scientist – Mesothelioma as an example. Platform Presentation, Department of Surgery Retreat, University of Maryland School of Medicine (January 2018)

• Transglutaminase is a mesothelioma cancer stem cell survival protein. International Society of Precision Cancer Medicine (ISPCM), Buson, Korea (March 17, 2018)

Charles Simone, II, MD (Radiation Oncology)

2015

• Mesothelioma Applied Research Foundation 12th International Symposium on Malignant Mesothelioma: Protons for Mesothelioma?

• Mesothelioma Applied Research Foundation Meet the Mesothelioma Experts: Focus on Mesothelioma Centers of Excellence

• Mesothelioma Applied Research Foundation Mesothelioma Scientific Workshop: Future of Clinical Trials

• New York Regional Conference on Malignant Mesothelioma: Radiation Oncology

2016

• SPIE Photonics West 2016: First Prospective Study Assessing the Combination of Photodynamic Therapy and Proton Radiation Therapy: Safety, Outcomes, and Potential Synergy When Treating Malignant Pleural Mesothelioma

2017

• 37th Meeting of the American Society for Photobiology: Advances in Photodynamic Therapy for Thoracic Malignancies: Frontiers for Mesothelioma and Lung Cancer

• Mesothelioma Applied Research Foundation International Symposium on Malignant Mesothelioma: Patient Selection for and Delivery of the Newest in Precision Radiation Oncology: Pencil Beam Scanning Proton Therapy

• NCI-IASLC-MARF Mesothelioma Clinical Trials Planning Meeting: Early Stage Mesothelioma

• National Capital Consortium, National Cancer Institute, Radiation Oncology Branch Grand Rounds: Malignant Pleural Mesothelioma: A Multimodality Approach to Treatment

Melissa Culligan, RN, BSN, MS (Thoracic Surgery Nursing)

2015

• Nursing Care of Patients Following Radical Pleurectomy and Intraoperative Adjuvant Treatment for Thoracic Malignancies, International Symposium on Malignant Mesothelioma, Alexandria, VA, March 2015.

2016

• A Coordinated Approach to Starting and Managing a Comprehensive Mesothelioma Service. International Mesothelioma Interest Group – International Conference, Birmingham, United Kingdom, May 2016.

• Challenges in Conducting Surgery-based Clinical Trials in Lung Cancer and Mesothelioma. International Thoracic Oncology Nursing Forum – Lung Cancer and Mesothelioma Workshop – Innovating Lung cancer and Mesothelioma Care. Vienna, Austria, December 4, 2016.

2017

• Overview of Clinical Research in Malignant Pleural Mesothelioma. NIH/MARF International Scientific Symposium on Malignant Mesothelioma, Bethesda, Maryland, March 2017.

• Evidence Based Care: Interpreting the Research and Enhancing Practice in the Pre-operative Support of Lung Cancer and Mesothelioma Patients. 18th IASLC World Conference on Lung Cancer, Yokahama, Japan – October 2017.

• Surgery vs Sterotactic Radiation Therapy for Lung Cancer and Mesothelioma - A Debate. International Thoracic Oncology Nursing Forum’s Lung Cancer and Mesothelioma Workshop – Excellence in Thoracic Oncology Nursing Care, Yokahama, Japan - October 15, 2017

2018

• IASLC Thoracic Oncology School of Nursing: The Role of Thoracic Surgery Nursing in the Care of Mesothelioma and Lung Cancer Patients – A Global Perspective. IASLC-Africa Conference on Lung Cancer, Tangier, Morocco – April 2018

• Patterns of Practice, A Global Perspective – Surgery and Systemic Pleural Mesothelioma Case Presentations. International Mesothelioma Interest Group – 14th International Conference, Ottawa, Canada, May 2018

• Translating Clinical Knowledge into Clinical Action – Surgical Treatment Modalities for Pleural Mesothelioma & Case Presentations. International Mesothelioma Interest Group – 14th International Conference, Ottawa, Canada, May 2018

APPENDIX 5

NATIONAL & INTERNATIONAL COMMITTEES

Joseph S. Friedberg, MD

2018-present Board of Directors, International Mesothelioma Interest Group (iMig)

2016-present NIH/IASLC Mesothelioma Clinical Research Task Force

2014-present International Mesothelioma Interest Group (iMig) Biennial Meeting Scientific Abstract Review Committee

2009-present Thoracic Surgery Section Editor, UpToDate (www.uptodate.com)

2011-present Editorial Board, Science World Journal

2011-present Editorial Board, Lung Cancer Management Journal

1997-present Reviewer, Annals of Thoracic Surgery

2003-present Reviewer, Journals of Thoracic and Cardiovascular Surgery

2006-present Reviewer, Journal of Surgical Research

1999-present Reviewer, Chest

Charles Simone, II, MD

2016-present National Cancer Institute Thoracic Malignancies Steering Committee Mesothelioma Working Group

2017-present International Representative for Radiation Oncology, International Mesothelioma Interest Group (iMig)

2014-present International Mesothelioma Interest Group (iMig) Biennial Meeting Scientific Abstract Review Committee

2015 Department of Deference Grant Reviewer Section: Peer Reviewed Cancer Research Program (PRCRP) of the Department of Defense Congressionally Directed Medical Research Programs (CDMRP) – Horizon-Mesothelioma (H-MESO) Award

Melissa Culligan, RN, BSN, MS

2015-present Chair – International Thoracic Oncology Nurse Forum

2012-present Member, International Association of the Study of Lung Cancer Nursing and Allied Health Committee

2014-2017 Mesothelioma Applied Research Foundation – Board of Directors

2016-present Editorial Board – International Journal of Clinical Research and Trials

2016-2017 National Institutes for Health/Mesothelioma Applied Research Foundation Scientific Symposium Planning Committee, March 2017

2017 Chair, UK-US International Mesothelioma Nursing Symposium, University of Maryland School of Nursing, March 24, 2017.

2017-2018 International Mesothelioma Interest Group 14th International Conference Scientific Subcommittee

2018-present Member, International Association of the Study of Lung Cancer Continuing Medical Education Committee



APPENDIX 6

COMMUNITY OUTREACH & CENTER PROMOTION

Objective and Strategy

The campaign objective was to raise consumer awareness of the comprehensive service

for mesothelioma offered at the University of Maryland Greenebaum Comprehensive

Cancer Center, with the long-term goal of increasing mesothelioma surgery and radiation

oncology volumes.

The campaign employed two digital tactics, targeting men and women 45+ who had

careers in the industries of construction, shipbuilding, auto mechanics, heavy industry,

military and the like or who liked mesothelioma awareness pages on Facebook within the

48 contiguous states and the greater multi-state UMMC service area: 1) a Facebook Event

Page and 2) a Facebook Promoted Posting.

These tactics promoted Dr. Joseph Friedberg and Dr. Charles Simone and their expertise

in treating mesothelioma to drive users to participate during the live stream. The pre-

promotion post included the call to action to leave a comment or question for answer

during the live stream.

Campaign outcomes were tracked by tactic through 1) traffic to the pre-event post, 2)

engagement during the live stream event, and 3) engagement with post-event post.

Facebook Live Campaign FY2018

Campaign Time Frame: 9/11/2017 to 9/30/2017

Event Date: 9/14/2017 at 2:00 PM EST

Campaign Report: Prepared on 10/16/2017



Campaign Highlights

1. The pre-event post ($931.91 spent between 9/11 -9/14) reached 33,317 people before the

event, with 2,008 post reactions (Like, Love, Haha, Wow, Sad, Angry), 129 post shares, 24

comments and 10 link clicks. In addition, 27 people liked UMMC’s Facebook page because of

the ad.

2. The post-event post ($3,190.27 spent between 9/19-9/30) drove a total of 428,052 impressions. This is the number of times someone saw the post on their news feed. The

reach of the post-event post was 260,191 unique individuals.

3. There was a total of 206,926 video views, with 153,536 people taking action (engaging

with UMMC in some way), 150 post reactions, and 43 shares. The number of people who

watched at least 25% (~10.5 minutes) of the video was 625, and 140 watched the video to

the end.

4. The same percentage of men and women watched the entire video, unusual

because women are typically more engaged in their family’s health matters.

The video proved slightly more popular with men younger than 65 and

women older than 65.

5. The video was a total of 41:39 in length. This resulted in a broad discussion

and provided the opportunity for viewers to engage at multiple points in the

live stream.

6. There were no questions on the post during and after the live stream, but

while the video was promoted, there were a number of comments and two

questions, as indicated in the images below.


Summary and Recommendation:

While only about 12 people were tuned in at any one time and no questions were asked during

the live event, this promotion gave UMMC an opportunity to let the region and a large swath

of the United States know that UMGCCC has a comprehensive mesothelioma diagnosis and

treatment service. The Mesothelioma page on the umgccc.org website received increased traffic

on 9/14 and the days following, and Colleen Norton, Mesothelioma Nurse Navigator, anecdotally

noticed an increase in new mesothelioma patients during the

second half of September.

Conversion data will be tracked over the next three months to

determine overall campaign effectiveness. We can reasonably

conclude that the responsiveness and traffic generated by the

campaign contributed to an increase in brand awareness and may

continue to impact patient volumes in the coming months.


T h e U n i v e r s i t y O f M a r y l a n d S c h o o l O f M e d i c i n e

M e s o t h e l i o m a Tr e a t m e n t & R e s e a r c h C e n t e r

ACKNOWLEDGEMENTSThe University of Maryland School of Medicine Mesothelioma Treatment and Research Center

gratefully acknowledges the support of the individuals and institutions that makes

our world-class care and research possible:

Mr. Peter G. Angelos

NIH grants: RO1CA120528-11A1 and U24OH009077-10

The University of Maryland Marlene and Stewart Greenebaum Cancer Center

29 South Greene Street

Baltimore, Maryland 21201

phone: 410-328-6366

fax: 410-328-0693

www.umms.org/umgccc/cancer-services/cancer-types/mesothelioma

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