Innovative treatment extends survival for patients with malignant mesothelioma, study shows

An innovative treatment has significantly improved survival rates for patients with malignant mesothelioma, according to results from a clinical trial led by Queen Mary University of London. Malignant mesothelioma is a rare but deadly type of cancer with few effective treatment options.

The phase 3 clinical trial, led by Professor Peter Slosalek from Queen Mary University and sponsored by Polaris Pharmaceuticals, is investigating malignant pleural mesothelioma, a rare and rapidly fatal cancer with limited treatment options. revealed a breakthrough in the treatment of (MPM).

Mick's journey with mesothelioma: “I now have five grandchildren and two great-grandchildren and I don't want to miss any of them.”

In the ATOMIC-meso trial, a randomized, placebo-controlled study of 249 patients with MPM, treatment with the new drug ADI-PEG20 in combination with conventional chemotherapy extended the median survival of participants by 1.6 months; It turns out that the period has quadrupled. 36-month survival compared to placebo chemotherapy.

This finding is important because the 5-year survival rate for MPM is one of the lowest among solid cancers, approximately 5-10%. This innovative approach represents the first successful combination of cancer metabolism-targeting drugs and chemotherapy developed for this disease in the past 20 years.

MPM is an aggressive, rare cancer that affects the lining of the lungs and is associated with exposure to asbestos. It is usually treated with powerful chemotherapy drugs, but these are rarely able to stop the progression of the disease.

The premise behind this new drug treatment is elegant in its simplicity: it starves tumors by cutting off their food supply. All cells require nutrients, including amino acids such as arginine, to grow and multiply. ADI-PEG20 works by depleting arginine levels in the bloodstream. For tumor cells that are unable to manufacture arginine because they lack the enzyme, this means that their growth is stunted.

The ATOMIC-meso trial began with Professor Slosalek's discovery that malignant mesothelioma cells lack a protein called ASS1, which allows the cells to manufacture their own arginine. This is the culmination of years of research. Since then, he and his team have been dedicated to using this knowledge to develop effective treatments for his MPM patients.

Professor Slosalek said: “It's really exciting to see the research into arginine starvation in cancer cells come to fruition. This discovery has been a breakthrough in my lab since its early stages, and is now possible with a new treatment, ADI-PEG20. is improving,” he said. “Mesothelioma affects the lives of patients. We thank all the patients and families, researchers and their teams, and Polaris Pharmaceuticals for their efforts in defining new cancer treatments. .”

This study demonstrates the power of discovery research that allows us to dig deep into the biology of mesothelioma and uncover vulnerabilities that can be targeted with ADI-PEG20.

Cancer Research UK is pleased to have been able to fund the early stages of this research, including preliminary clinical trials that established the safety and efficacy of the drug. ”

Dr Tayyaba Jiwani, Cancer Research UK Science Engagement Manager

Studies are underway to evaluate ADI-PEG20 in patients with sarcoma or glioblastoma multiforme (a type of brain tumor) and other cancers that rely on arginine. The success of this novel chemotherapy in MPM suggests that this drug may also be useful in treating multiple other cancer types.

Mick's mesothelioma journey

Mick worked in a factory boiler room in the 1970s, where he was exposed to asbestos. In 2018, he went to see a doctor after he became unwell and lost three stone in weight. He became anemic and was eventually diagnosed with mesothelioma.

“It was a bit of a shock. I was given four months to live,” Mick explains. His doctor referred him to Professor Slosalek, who enrolled him in his ATOMIC-meso exam. “I always believed in Peter. I said, 'I'm going to win. You're not going to get rid of me.'” And five years later, here I am. ”

For two years, Mick visited St. Bartholomew's Hospital every week, accompanied by his wife Jackie or one of his children or grandchildren. “We ended up giving him two injections of the new treatment, one in each arm, and there were no serious side effects,” Mick explains. “I met many others at the trial. As time went on, some disappeared. But I continued.”

Mick received compensation from his former employer, who was responsible for the asbestos exposure that ultimately caused his mesothelioma. Approximately 80% of mesothelioma cases are caused by workplace exposure.

Two and a half years after Mick enrolled in the ATOMIC-meso trial, his mesothelioma returned and he underwent a second course of treatment, this time with immunotherapy. He experienced additional side effects from this treatment, including encephalitis. However, his cancer remains under control and he was recently able to celebrate his 80th birthday. Professor Slosalek and his team plan to study why certain patients like Mick benefit so much from ADI-PEG20, and discover ways to extend this benefit to more people.

“This trial changed people's lives,” Mick said. people with mesothelioma, will allow us to live longer. I now have five grandchildren and his two great-grandchildren and I don't want to miss any of them. ”