Mesothelioma Research

Mesothelioma Research
Mesothelioma Research

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Some of the experimental technology being used with mesothelioma treatment involves methods with differing approaches to the same task: slowing the spread of malignant mesothelioma cells and killing the cells that exist. Elsewhere on this website we discuss the use of gene therapy, a new approach to radiation therapy, immunotherapy and photodynamic therapy. All of these tools are technology oriented and all of them represent refinements in medical engineering achievements.

These procedures can be thought of as mesothelioma research in the sense that there will be no record of the value of their use until there is a track record for each of them. Each of them have one characteristic in common, and that is the goal of zeroing in on malignant cells.
Research in Chemotherapy for Mesothelioma Cancer

Onconase

In January of 2007 Alfacell Corporation, a biopharmaceutical company focused on ribonuclease therapeutics for cancer announced that the FDA granted orphan-drug designation in the United States for the company's drug Onconase (ranpirnase), for treatment of malignant mesothelioma. At that point Alfacell was evaluating Onconase in Phase III clinical trial for unresectable malignant mesothelioma. Unresectable mesothelioma is a case of the disease that has gone beyond the point where surgical removal of malignant tissue is a worthwhile endeavor.

Orphan drug designation is a status wherein a company has seven years of marketing exclusivity. In this case it was the use of Onconase to combat cell development in malignant mesothelioma. Orphan status also made Alfacell eligible for certain tax advantages and grant programs to advance the use of the drug.

In May of 2008 Alfacell announced that their Phase III trial using Onconase in conjunction with doxorubicin had shown no significant improvement in survival time for patients as compared with a group that was treated solely with doxorubicin. They did show some progress, however, with a group of patients that had not responded to earlier treatment with another chemotherapy regimen. The measure of success, however, was an average survival time of 10.7 months compared to 8.5 months in the control group.

In 2009 the company went into yet another Phase III trial at the behest of the FDA because Oncanase had shown significant results in a subset of patients who had failed in a previous chemotherapy treatment. Oncanase remains in the late stages of clinical trials for treating unresectable mesothelioma and has gone to Phase II trials for treatments of other forms of cancer. Alfacell has recently changed its name to Tamir.

Alimta and Cisplatin

In 2004 the FDA issued its first approval for a drug meant specifically for the treatment of malignant mesothelioma. That drug is pemetrexed, known also under its brand name Alimta. It is generally used in combination with a platinum compound known as cisplatin. Both drugs attack the growth of cancerous cells and seem to work well together. Pemetrexed cuts off the supply of certain enzymes to cancer cells, while cisplatin has a miniscule amount of platinum at its core – which is toxic to cancerous cells.

Pemetrexed is considered a primary chemotherapy choice with patients for whom surgery is not an option. Drug manufacturer Eli Lilly conducted a study with patients in stage III – IV that showed that when combined with cisplatin, pemetrexed provided an average increase in survival time among patients from nine months to a little over twelve months. Pemetrexed also provided notable relief from symptoms of the disease including shortness of breath and chest pain.

There have been other drugs tested with pemetrexed for both pleural mesothelioma and peritoneal mesothelioma. Because of the relatively positive results seen using pemetrexed in combination with another medication, researchers have been conducting clinical trials to see if there are choices besides cisplatin for patients that have trouble tolerating platinum compounds. As of July 2010 there are over one hundred clinical trials listed by the National Cancer Institute involving pemetrexed in various combinations for chemotherapy.
Photodynamic Therapy Research for Mesothelioma

This form of treatment uses a light sensitive drug that can be targeted to an area where malignant cells are located and then activated by light beams of a certain frequency. Because the light can only penetrate a short distance, there has been some experimentation with using photodynamic therapy during the course of surgery, when the tissue to be treated is fully exposed. Photodynamic therapy has been in use for over fifteen years; researchers continue to look for ways to utilize the technology within the limits that the use of light present.

Sources:

1. Oncanase NDA Update, Drugs.com, http://www.drugs.com/nda/onconase_090128.html
2. Pemetrexed in Malignant Pleural Mesothelioma, Oncology, 2004, http://www.cancernetwork.com/display/article/10165/105768
3. Pemetrexed Plus Gemcitabine As First-Line Chemotherapy for Patients With Peritoneal Mesothelioma, Journal of Clinical Oncology, Simon et al, July 2008, http://jco.ascopubs.org/cgi/content/abstract/26/21/3567
4. Clinical Trials Database, National Cancer Institute, http://www.cancer.gov/search/ResultsClinicalTrials.aspx?protocolsearchid=7957447
5. Surgery and Photodynamic Therapy in Treating Patients With Malignant Mesothelioma, Clinical Trials Database, National Cancer Institute, http://www.cancer.gov/clinicaltrials/RPCI-RP-9812#StudyIdInfo_CDR0000269674



Mesothelioma Research