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VEGF-Inhibitor Looks Promising for Malignant Mesothelioma

ByAlex Strauss

3110504_scientistsThere is more encouraging news about the monoclonal antibody bevacizumab (Avastin) and its potential to boost the effectiveness of chemotherapy for people with malignant pleural mesothelioma.

A pair of oncology researchers from Texas have just released their summary of the the most recent published studies on bevacizumab. They conclude that, for the right patients, bevacizumab may improve mesothelioma outcomes and extend survival by blocking tumor blood vessel formation (angiogenesis).

This ability of bevacizumab to help standard mesothelioma chemotherapy work better is why the drug has been included as a possible first-line mesothelioma treatment in the National Comprehensive Cancer Network guidelines since 2016.

Bevacizumab for Mesothelioma Therapy

Bevacizumab is a monoclonal antibody that inhibits angiogenesis in mesothelioma tumors by blocking VEGF, a protein that stimulates new blood vessel formation.

In 2016, in a study that went by the acronym ‘MAPS’, French researchers randomly assigned 448 pleural mesothelioma patients to receive either standard two-drug chemotherapy with pemetrexed and cisplatin or a three-drug combination with bevacizumab. The three-drug combination lowed the risk of death from mesothelioma by 23 percent.

“The MAPS study represents a significant step forward in the treatment of unresectable malignant pleural mesothelioma and has established the combination of cisplatin, pemetrexed, and bevacizumab as a reasonable option for appropriately selected MPM patients who are candidates to receive bevacizumab,” write Pavel Levin, MD, PhD, and Jonathan Dowell, MD, of the University of Texas Southwestern Medical Center, authors of the new summary report.

As Drs. Levin and Dowell explain in OncoTargets and Therapy, after “extensive evaluation”, the news about bevacizumab and other drugs that block VEGF in mesothelioma tumors, continues to be encouraging.

Limitations of Avastin in Mesothelioma Treatment

Although multiple studies have confirmed the potential of bevacizumab in mesothelioma treatment, there are still limitations to its use Because it has been linked to cardiac-related complications, mesothelioma patients who want to try it must be carefully-screened to avoid serious side effects.

In addition, Drs. Levin and Dowell acknowledge that some of the studies on bevacizumab for mesothelioma have been small and most have focused primarily on people with the epithelioid variety of mesothelioma, so that the benefits of bevacizumab for people with other types of mesothelioma are unclear.

Even with these limitations, bevacizumab and drugs like it continue to be the subjects of new mesothelioma studies, some of which suggest that these drugs may fight mesothelioma in more than one way.

“Emerging evidence also suggests that VEGF may suppress T-cell-mediated immune response, and therefore, anti-VEGF therapies may augment the effect of immunotherapy in cancer,” write Levin and Dowell. Immunotherapy is currently one of the most exciting and intensely-studied approaches to combating mesothelioma and other types of cancer.

In addition to bevacizumab, other VEGF-inhibitors that have been shown to have an impact on mesothelioma chemotherapy  without causing prohibitive complications include sorafenib (Nexavar), cediranib (Recentin), and nintedanib (Ofev).

Source:

Levin, PA, and Dowell, JE, “Spotlight on bevacizumab and its potential in the treatment of malignant pleural mesothelioma: the evidence to date”, April 7, 2017, OncoTargets and Therapy, 2057-2066

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