Another new study suggests that adding a third drug to standard mesothelioma chemotherapy might lead to better treatment outcomes.
The newest report focuses on the monoclonal antibody, bevacizumab (Avastin). Japanese researchers back up what others have found. They say most patients did well on a combination of Avastin and standard mesothelioma chemotherapy.
Drug Blocks Blood Vessel Formation
Like all body tissues, mesothelioma tumors need blood vessels to grow and thrive. Angiogenesis is the process by which tumors create their own new blood vessels.
Avastin works by blocking this process. Without an adequate blood supply, a mesothelioma tumor may be more susceptible to standard mesothelioma chemotherapy.
Doctors already use Avastin to treat lung cancer, colon cancer, glioblastoma, and renal-cell cancer. The new study is the first one to evaluate it for Japanese pleural mesothelioma patients.
Making Standard Mesothelioma Chemotherapy Better
Chemotherapy is only moderately effective against malignant mesothelioma. But it is the best hope for patients who are not candidates for mesothelioma surgery.
Standard mesothelioma chemotherapy combines Alimta (pemetrexed) and a platinum drug. The platinum drug is usually cisplatin or carboplatin. The combination gives patients an average of four extra months of life.
The goal of the Japanese trial was to see if Avastin could safely extend that. Seven pleural mesothelioma patients enrolled. They received six rounds of Avastin plus standard mesothelioma chemotherapy. Patients could stay on Avastin for up to a year.
The Avastin regimen was not without drawbacks. Every patient had some sort of gastrointestinal problem. Two patients dropped out because of these issues.
On the up side, the combination did seem to help. Mesothelioma tumors stopped growing in four patients and shrunk in two patients. The researchers conclude that adding Avastin to standard mesothelioma chemotherapy has merit.
“Bevacizumab plus cisplatin/pemetrexed, then bevacizumab, was well tolerated in Japanese patients with malignant pleural mesothelioma,” they write.
Other Benefits of Chemotherapy with Avastin
Avastin may have other benefits for mesothelioma patients. In France, chemotherapy with Avastin is already standard-of-care for mesothelioma. A 2019 French study showed the combination reduced pain and cut the risk for peripheral neuropathy. (Some chemotherapy drugs can damage nerves that control the arms and legs.)
Three years earlier, the French MAPS study showed that adding Avastin to standard mesothelioma chemotherapy improved survival by 23 percent. The US National Comprehensive Cancer Network guidelines list it as an option for first-line mesothelioma treatment.
Nakano, T, et al, “Bevacizumab plus cisplatin/pemetrexed then bevacizumab alone for unresectable malignant pleural mesothelioma: A Japanese safety study, September 7, 2020, Asia Pacific Journal of Clinical Oncology, Epub ahead of print, https://pubmed.ncbi.nlm.nih.gov/32893992/
Eberst, G, et al, “Health-related Quality of Life Impact from Adding Bevacizumab to Cisplatin-Pemetrexed in Malignant Pleural Mesothelioma in the MAPS IFCT-GFPC-0701 Phase III Trial”, June 7, 2019, Clinical Cancer Research, Epub ahead of print, http://clincancerres.aacrjournals.org/content/early/2019/06/07/1078-0432.CCR-18-2860