Mesothelioma researchers in Italy have developed a new surgical technique with the potential to dramatically increase the odds of surviving malignant pleural mesothelioma.
Pleural mesothelioma is a rare and aggressive cancer that grows on the membranous tissue (pleura) surrounding the lungs. It is most common in people who have ever lived or worked in the presence of deadly asbestos dust.
The new technique involves placing a drug-coated polymer film directly on the mesothelial surface after tumor-removal surgery as a way to prevent recurrent pleural mesothelioma.
In a new article in the European Journal of Pharmaceutical Science, researchers at the University of Parma say the film “almost completely prevented tumor recurrence” in treated mice.
Battling Recurrent Mesothelioma
The typical treatment options for people diagnosed with malignant pleural mesothelioma include surgery, radiation therapy and/or chemotherapy with pemetrexed (Alimta) and cisplatin. Several new immunotherapy drugs have also shown promise.
Unfortunately, none of these treatments is considered to be a cure for mesothelioma since tumors nearly always grow back, often in the same place. This is known as local recurrence.
One reason this happens is that it is nearly impossible to find and destroy or remove every single mesothelioma cell. Often, new mesothelioma tumors arise from those residual cells.
New Film Destroys Residual Mesothelioma Cells
To combat the problem of locally recurrent mesothelioma, the University of Parma researchers developed a thin, flexible polymer film that can be coated with pemetrexed or cisplatin and placed wherever it is needed to kill cancer cells.
According to the new report, when tested on lab mice infected with mesothelioma, the cancer-killing power of the pemetrexed-loaded film was on par with other more common methods of delivering the drug, including intravenously or by rinsing it through the intrapleural cavity.
But the real magic happened when the team added cisplatin-loaded film to the mix. Infected rats that were treated with both kinds of drug-coated films had almost no mesothelioma recurrence.
“The local administration of drug-loaded polymer implants appears an ideal chemotherapy strategy, especially for patients in which surgery is already selected as a viable therapeutic option,” conclude researchers Fabio Sonvico and Stefano Barbieri and their colleagues.
A Safer Mesothelioma Treatment Option?
Another potential advantage to the coated polymeric films over other types of drug delivery is that they may be less toxic to healthy cells.
In an article published earlier this year by the same group of researchers in the Journal of Thoracic Disease, the team says mesothelioma-infected sheep treated with cisplatin-coated film after surgery ended up with higher concentrations of the drug in their blood than sheep who had either intravenous or intrapleural chemotherapy.
In spite of the higher plasma concentration of cisplatin, these animals also experienced “a significant reduction of treatment-related toxicity” over the other test subjects.
Sonvico, F, et al, “Combined hyaluronate-based films loaded with pemetrexed and cisplatin for the treatment of malignant pleural mesothelioma: Preliminary evaluation in an orthotopic tumor recurrence model”, July 17, 2018, European Journal of Pharmaceutical Science, Epub ahead of print
Ampollini, L, et al, “Polymeric films loaded with cisplatin for malignant pleural mesothelioma: a pharmacokinetic study in an ovine model”, January 2018, Journal of Thoracic Disease, Supplemental 207-220