Did You Know?
Mesothelioma patients can choose from a variety of experimental drug treatments.
New mesothelioma and anti-cancer drugs are constantly being researched and developed. Such drugs are required by the Food and Drug Administration (FDA) to go through extensive clinical trial testing during which their safety and efficacy is monitored.
The patients who choose to participate in these clinical trials typically suffer from a highly advanced type of cancer. Rather than electing to submit to traditional s that have proven ineffective in combating the rare asbestos cancer, patients can instead choose from a variety of experimental treatments. While such experimental treatments are more risk-oriented than traditional treatment modalities, they present cancer patients with a more proactive medium through which to fight to live.
Mesothelioma Drugs
Veglin
Vegin is a new experimental drug manufactured by VasGene Therapeutics, Inc., Veglin is an anti-angiogenesis drug undergoing clinical trials at the University of Southern California's Keck School of Medicine. Veglin inhibits VEGF proteins, halting the formation of blood vessels and limiting the ability of tumors to grow and spread. Veglin is an antisense oligonucleotide, meaning that it can bond to messenger RNA (nucleic acid that directs protein production) and block the production of VEGF proteins.
If Veglin is successful in blocking tumor secretion of VEGF proteins, it is believed that it will be capable of preventing metastasis while simultaneously killing existing cancer cells.
ALIMTA [ (pemetrexed) is now available on expanded access basis.
ALIMTA is now available for people with malignant pleural mesothelioma, a cancer usually associated with exposure to asbestos. As of July 9, 2002 the Food and Drug Administration agreed to place ALIMTA in an expanded access program, which gives patients access to an agent that isn't yet commercially available, although the sponsor is actively pursuing marketing approval. Eli Lilly is pursuing approval of ALIMTA in combination with cisplatin for the treatment of malignant pleural mesothelioma, a disease that causes tumors to grow in the linings of the lung, or pleura. Patients live an average of six to nine months following diagnosis. The company said results of a Phase III trial showed that patients treated with ALIMTA and cisplatin combined lived longer and had less pain and shortness of breath, than patients treated with cisplatin alone. In the trial, the most common side effect from cisplatin and ALIMTA was a decrease in infection- fighting white blood cells. Under the expanded access program, ALIMTA will be given free of charge to patients who meet medical eligibility requirements.
L-NDDP (aroplatin).
Intrapleural administration is intended to exceed the usefulness of other platinum drugs like Cisplatin that are limited by toxicity and drug resistance.
Endostatin.
Has been shown to inhibit a tumor's ability to grow blood vessels without destroying normal healthy cells. Works with angiostatin. Lovastatin. A cholesterol drug shown to potentially inhibit the growth of cancer cells.
Intrapleural interferon gamma.
The anti-cancer drug, Interferon Gamma is directly administered into the affected area.
A Word About Clinical Trials
Clinical trials are separated into four distinct phases:
Phase I & II: the first two phases of any clinical trial revolve around drug safety. Candidates for phases I & II include patients with an advanced form of a given disease (in this case, cancer), who are given the opportunity to try experimental treatments.
Phase III: the third phase of any clinical trial revolves around comparing the drug with standard forms of treatment proven to work. Participants of phase III have a more optimistic prognosis while also meeting clinical trial criteria.
Phase IV: the fourth and final phase of any clinical trial coincides with the preliminary marketing of the drug. Studies gather information on the drug's effect in various populations while monitoring any long-term side effects.
Options - Drug Therapy
Traditional Chemotherapy:
This traditional approach uses special anti-cancer (cytotoxic) medicines and chemicals to try to kill the malignant cells. Often, it is offered as an additional therapy alongside radical surgery and/or in combination with radiation therapy or immunotherapy, particularly when the cancer has spread beyond an operable area. Many drugs have been tried; however all have met with only limited success against malignant mesothelioma.
The chemotherapeutic agents can be administered either systemically (in the blood stream) or intrapleurally (in the pleural cavity itself.) These cytotoxic drugs are very potent and can have many severe side effects which you should discuss with your doctor.
Further Resources:
Understanding Chemotherapy - detailed information on chemotherapy, its side effects and current research:
http://www.cancerbacup.org.uk/Cancertype/
Mesothelioma/Treatment/Chemotherapy
University of Pennsylvania Cancer Center's information page on chemotherapy: http://www.oncolink.org/types/article.cfm?c=3&s=5&ss=603&id=6998
Search the National Cancer Institute web site for current chemotherapy trials.
Malignant mesothelioma of the peritoneum is both rare and difficult to treat. Peritoneal perfusion chemotherapy has recently been used in patients with secondary peritoneal carcinomatosis with promising results. See E. De Bree, et al. - Malignant peritoneal mesothelioma treated by continuous hyperthermic peritoneal perfusion chemotherapy", in Annals of Oncology, 11:753-756.
A study comparing standard combination chemotherapy with infusional carboplatin. See White, S.C., et al. - "Randomized phase II study of cisplatin-etoposide versus infusional carboplatin in advanced non-small-cell lung cancer and mesothelioma" in Annals of Oncology, February 2000; 11(2):201-206
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