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Business Group Seeks Probe of Asbestos Claims

WASHINGTON (Reuters) - April 8, 2005 - The head of the largest U.S. business association has asked the Justice Department to investigate "compelling evidence of fraud" in asbestos injury claims filed across the country, the group said on Friday.

The request from Tom Donohue, president of the U.S. Chamber of Commerce and an influential Washington lobbyist, marked a new business offensive against hundreds of thousands of asbestos suits that have pushed dozens of companies into bankruptcy.

President Bush has also denounced the flood of claims, saying many are frivolous, bad for the U.S. economy and clogging the courts. He has asked Congress to rein them in, and some senators are trying to draft legislation to do so.

Asbestos victims and labor groups say the real problem is an epidemic of asbestos-related disease caused by exposure to the lung-scarring mineral, in widespread use for decades as an insulator and fire retardant, and illnesses including cancer.

Partly as a result of the congressional interest in asbestos claims, "considerable evidence has come to light indicating the existence of substantial and systematic fraud in asbestos litigation," Donohue wrote in a letter to Attorney General Alberto Gonzales that was released by the Chamber.

"I request that the Department of Justice immediately open a formal investigation into the conduct of lawyers, doctors and others who are responsible for the explosion in meritless and abusive asbestos claims across the country in recent years."

A Justice Department spokesman said he could not confirm receipt of the letter or comment on the matter.

While accusing no one specifically of fraud, the Chamber noted several developments to bolster its call for a probe, including a Texas case involving litigation over silica, another lung-scarring mineral.

Doctors in that case have testified that they had diagnosed silicosis in patients they had never met. Some of the same doctors have diagnosed asbestos-related diseases in thousands of cases, the Chamber said.

The business group also cited a study published in an academic journal last year that questioned whether hundreds of chest X-rays offered as evidence in asbestos injury lawsuits were properly interpreted by radiologists.

An AFL-CIO official suggested Donohue's call for an investigation targeted senators discussing establishing a $140-billion privately financed fund to pay asbestos claims, while ending the victims' rights to sue.

"It's another way of pressuring lawmakers to reduce the size of the fund, by representing the situation as being claims that are not real," said Peg Seminario, the AFL-CIO's official in charge of occupational health.

She said U.S. deaths from asbestos-related disease were still increasing, citing government statistics that there were 2,573 deaths in 2002 from mesothelioma, a lethal cancer linked to asbestos.

Iressa and Erbitux Compared in Lung Cancer

8/16/05 - In an comparison study of Iressa (gefitinib) and Erbitux (cetuximab) in non-small cell lung cancer (NSCLC), researchers from the Dana-Farber Cancer Institute, Boston, found that while both drugs killed cells containing a normal but overactive epidermal growth factor receptor (EGFR) molecule, only Iressa had an effect on cells carrying the mutant EGFR protein. The monoclonal antibody drug Erbitux was not effective on those cells.
“The question we were faced with after the identification of EGFR mutations was, do all drugs act the same way on the mutant receptor?” says Pasi Jänne, MD, PhD, assistant professor of medicine, Dana-Farber, and senior author of the study, published this week in the Journal of the National Cancer Institute [Mukohara, et al., vol. 97, pp. 1185-1194 (2005)].

Last year, Jänne’s group contributed to the research that identified the mutations as being very important in patients with lung cancer and being predictors of clinical and radiographic benefits to patients for those receiving the EGFR tyrosine kinase inhibitors, Iressa and Tarceva (erlotinib).

With all of the different ways to inhibit EGFR, Jänne’s group then wondered about using an antibody that is directed at the extracellular domain and if that would be effective in an EGFR mutant.

To determine whether Erbitux might be another option for NSCLC patients who carry the EGFR mutation, they treated lung cancer cell lines with Iressa and Erbitux. Both drugs blocked the excess signals in cells with normal EGFR, but only Iressa was significantly effective in those carrying a mutant EGFR.

“The information we generated from the cell lines suggest that only the tyrosine kinase inhibitors are going to be effective,” says Jänne.

They then were able to generate some information from a limited number of patients who received both therapies sequentially. These patients all had an EGFR mutation and they all received either the Erbitux first followed by Iressa, or vice versa. All of them seemed to respond to the Iressa but none of them responded to the Erbitux, Jänne says. “If you have an EGFR mutation, the best way to inhibit it is with the tyrosine kinase inhibitor and antibodies are not going to be very effective, based on our information.”

Erbitux is a monoclonal antibody drug that binds to a portion of the EGFR receptor that extends outside the cell. The researchers say that this difference in action may explain the lack of effect against the mutant EGFR cells.

Erbitux is effectively used in colon cancer, Jänne says, which is not as associated with mutations of EGFR. “What our study does not answer is why the antibody works in some colon cancers and in some lung cancers. All our study suggests is that it is not the mutation that is the predictor for sensitivity as it is for the small molecule inhibitors.”

The researchers benefited from being able to study not just the cell lines, but the patient data as well, where they found the same correlation. “The patient data strengthens the finding from the in vitro study,” says Jänne.

He says they would like to study more patients who have received these drugs to uncover the determinants for drug efficacy or how to choose patients that would respond to the antibody.

“You can envision that, using molecular approaches, we can choose a population of patients to offer the small molecule inhibitor. You may also be able to choose another population of patients that is most likely to respond to the antibody. As we learn more about the importance of these genetic alterations and EGFR, we will be able to do that in future studies.”

By Elizabeth Tolchin

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