Patients diagnosed with malignant pleural mesothelioma have few treatment options available to them, and those that exist deliver results that are marginal at best. Most patients die within two years of being diagnosed. In an effort to extend survival time, researchers at three different United Kingdom medical centers have begun a trial that takes an unusual three-stage approach: they will test the patients’ tumors for predictive biomarkers, and then provide treatment based on what biomarkers are identified. At the end of the study they will analyze the patients’ tissue for genetic responses to determine which treatments provided the best response for each molecular profile.
Mesothelioma Trial is Still Open to Patients
According to Dean A. Fennell, MD, PhD, professor and chair of thoracic medical oncology, University of Leicester and University Hospitals of Leicester NHS Trust, there are currently 120 mesothelioma patients enrolled in the MIST trial, and there are still openings for patients who had prior chemotherapy. Because the approach is being used to analyze different treatment approaches and tumors with different markers, there are several arms of the study, with some already completed and others yet to begin.
One of the studies that has already been completed identified patients with BRCA1/BAP1-negative mesothelioma. The researchers treated it with rucaparib (Rubraca), a PARP inhibitor. The goal of each arm of the study is determining the effectiveness of this personalized approach in controlling the rate of growth of the tumor.
Genetically-targeted therapeutics seen as best hope for treatment
There are a variety of mutations seen in mesothelioma patients, with the most common one found in the BAP1 gene. The trials that have been most successful have inhibited the drivers of these mutations, though combining chemotherapy with immunotherapy has also offered some hope. Another strategy the team has been assessing has involved depriving mesothelioma tumors of arginine, a complex amino acid.
In taking a more personalized approach to mesothelioma treatment, the researchers have acknowledged that patients who have certain mutations that stop tumor suppression, they are likely to do far worse. By restoring tumor suppressors they hope that they can either substantially slow the growth of mesothelioma tumors, or kill their cells entirely.
This type of new technology holds great hope for mesothelioma treatment, though it may come too late for those who already have been diagnosed with the disease. For information on the best treatments and resources available, contact the Patient Advocates at Mesothelioma.net today at 1-800-692-8608.