We met with Professor Lang Lazdunski again a few weeks ago.

Paul was a bit nervous because he's been experiencing tighness in his chest which can only be soothed by exercise.

Prof Lang thought his experience likely caused by adhesions caused by surgery & also his extra-sensitivity to radiotherapy.

He explained that Paul has a relatively slow growing type of epithelioid Mesothelioma showing a tubulopapillary pattern. His tumour showed a loss of BAP1 staining indicating BAP1 mutation or another DNA repair mutation that could potentially be targeted by PARP inhibitors. In addition his tumour cells are stained with 1-5% PD-L1, which means he would certainly qualify for 2nd line immunotherapy on the grounds of fitness.

He recommended 6 monthly PET-CTs but no formal therapies at this time.

He reassured us that clinical understanding of molecular mechanisms leading to cancerisation is so much better these days .. there are many more new therapies. He also revealed he has patients who are alive and cancer-free 10 years following surgery and adjuvant chemo.

What a terrific chap and tonic. Every time we see him he gives us HOPE.

Wish we could bottle him and send him out to every MPM patient out there..

I found an article he published in March 2018.

Interesting reading. (gave me hope anyway!)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5906350/