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Chemoprevention of Mesothelioma: A Neglected Approach?

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A group of researchers in Italy is calling for renewed study of a mesothelioma prevention approach they say has been ignored for too long.

The method, called chemoprevention, involves using low doses of targeted toxins to seek out and kill cells that have the potential of turning into mesothelioma.  Ideally, these agents are designed to latch onto compounds that are only produced by pre-cancerous cells, minimizing the risk to healthy cells.

This idea may be particularly valuable for malignant mesothelioma.  Although the cause – asbestos exposure – is well-known,  there is no way to keep exposed individuals from developing the disease. And because the early symptoms of mesothelioma are typically mild and may mimic other, less serious, conditions, mesothelioma is frequently diagnosed in its late stages when treatment is often less effective.  Since it is relatively easy to identify people at high risk for mesothelioma, the Italian researchers say prevention may be the best way to save lives.

“Exposed individuals may be offered medical surveillance or compensation, but nothing is currently being done to lower their specific cancer (mesothelioma) risk,” the team writes in a new report in Anticancer Research.

In an effort to determine the status of research into chemoprevention of mesothelioma, the team compiled a list of all the studies that have been done on the method.  They found forty-six articles on five projects but were surprised to find that no new chemoprevention trials have been set up for mesothelioma for twenty years, despite what they call “considerable advances” in the area of chemoprevention.

Their report concludes, “A reconsideration of possibilities offered by chemoprevention should be encouraged. New trials based on the most recently characterized molecules should be planned.”

The drug ranpirnase (Onconase), a chemotherapy agent with low toxicity, is believed to be one of the best candidates for chemoprevention of mesothelioma.  Derived from the egg cells of the northern leopard frog, Onconase received orphan drug status from the FDA in 2007. It works by disrupting the RNA and preventing reproduction in targeted cells. Noted mesothelioma researcher Michelle Carbone, MD, of the University of Hawaii’s Cancer Research Center, who has conducted clinical trials on Onconase, has called the drug’s mesothelioma prevention potential an “exciting development.”

More than 25 million people worldwide are exposed to asbestos, which is still being mined and used, despite its toxicity. Every year, over 2,500 people are diagnosed with mesothelioma in the U.S.

Sources:

Neri, M, “Chemoprevention of Asbestos-linked Cancers: A Systematic Review”, March 2012, Anticancer Research, pp. 1005-13.
“Onconase has potential as chemopreventive agent in mesothelioma, reports world-renowned mesothelioma researcher at AACR annual meeting”, April 18, 2001, Drugs.com.

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