In edition 109 of BC Disease News we examined new mesothelioma research. Now we can report that in August 2016, a unique drug derived from the Caribbean Sea squirt has shown promise in stopping the growth of mesothelioma tumour cells.
Researchers at the University of Vienna in Austria have discovered that trabectedin, a toxin the coral-like animal uses against predators, may be an effective mesothelioma treatment. Group leader at the University of Vienna, Walter Berger, has said it looks “very promising” at this point.
In the study, published by the Molecular Cancer Therapeutics journal in early August, Berger’s team focus on the development of novel strategies for therapy-refractory cancers, such as mesothelioma, brain tumours and lung cancer. The study demonstrates how trabectedin serves as an effective chemotherapy-like agent, which targets DNA and has been delivering an immune response. It also showed good synergy when combined with cisplatin, a cytotoxic drug currently used in chemotherapy for cancer treatment.
Trabectedin could prove to be a major development in the treatment of malignant pleural mesothelioma. .
Five sites in Italy are currently conducting the only clinical trial involving trabectedin and mesothelioma. Early results are again said to be promising.
Elsewhere, there is new evidence that manipulating the process of protein synthesis inside cancer cells could be vital to improving outcomes for certain mesothelioma patients.
A new study, published in the Journal of the American Medical Association (JAMA) Oncology suggests that using a drug to lower the levels of the amino acid, arginine, can slow the spread of pleural mesothelioma and extend survival in patients who are deficient in a particular enzyme.
Malignant mesothelioma is highly resistant to most kinds of cancer treatments and patients are often at a loss as to what to try next when chemotherapy, surgery and radiation fail. This new study suggests that the new type of therapy could help conventional treatments to work more effectively.
The JAMA Oncology research demonstrates the importance of arginine, an amino acid necessary for mesothelioma cells to produce the proteins that allow them to live and replicate.
A multi-centre, randomised clinical trial demonstrated that 68 of 201 mesothelioma tumours were deficient in argininosuccinate synthase (ASS1), an enzyme necessary for arginine synthesis. In ASS1-deficient patients, using a drug to artificially reduce the amount of arginine in the body made their malignant mesothelioma cells more responsive to the effects of standard chemotherapy treatments. After four months of weekly doses of the arginine-lowering drug, more than half of the 68 mesothelioma patients experienced stability.
Elsewhere, this month, a new case report has led to researchers’ optimism about the potential benefits of a highly targeted radiotherapy technique called Intensity Modulated Radiotherapy (IMRT) in people with malignant pleural mesothelioma. IMRT is a form of radiotherapy that allows radiologists to precisely deliver radiation in a shape that conforms to the shape of a mesothelioma tumour. This is important because mesothelioma tumours grow on the pleural membrane and tend to be irregularly shaped, which makes it difficult to treat them with less conformal radiotherapy techniques. Furthermore, tumours are typically located adjacent to critical organs such as the lungs and heart. Radiotherapy plans must take this into account to protect tissues from radiation damage.
The Italian case report details the treatment of a 73-year-old mesothelioma patient who was administered a potentially lethal dose of radiation into his tumour, following a relapse 10 months after a surgery and chemotherapy. He suffered no serious side effects from the high dose of radiation and there was no progression in the mesothelioma in the 14 months after the IMRT. The patient is still alive 32 months after diagnosis.
Finally, it is not only the treatment of mesothelioma which has seen recent developments, it has also recently been reported that breath screening may aid in detecting early mesothelioma.
In a study at Ghent University, researchers analysed the breath of 66 study participants, including 23 with malignant pleural mesothelioma, for volatile organic compounds.
The study found that people with mesothelioma (and those who have been exposed to asbestos) tend to exhale different levels of volatile organic compounds than healthy people do.
According to a summary of the study published in the Journal of Breath Research, the test was 76% accurate at distinguishing the mesothelioma patients from either the asbestos-exposed people or the healthy controls.
When it came to distinguishing between the asbestos-exposed people and those with mesothelioma, the test had an 87% accuracy.
At present, there is no reliable way to screen for mesothelioma. Belgian researches say they are hopeful that breath analysis may improve the odds. The paper concludes:
“Breath analysis by MCC/IMS allows malignant pleural mesothelioma patients to be discriminated from controls and holds promise for further investigation as a screening tool for former asbestos-exposed persons at risk of developing malignant pleural mesothelioma.”
The study could prove vital in the future early detection of mesothelioma in patients which may improve survival rates.