The drug, called trabectedin (Yondelis), received FDA approval for advanced sarcomas and unresectable ovarian cancer in 2015. Now, there is evidence that it might offer a more effective way to combat mesothelioma, too – especially when combined with other drugs.
Mesothelioma Incidence Still Rising
Pleural mesothelioma, also known as the “asbestos cancer”, is extremely rare but also extremely deadly, largely because it is resistant to standard cancer chemotherapy. Most patients with mesothelioma do not survive beyond about a year after diagnosis.
Even though many countries have now banned asbestos because of its link to mesothelioma and other cancers, rates of the disease are still rising in some places, including Italy.
What is Trabectedin?
In the new study, researchers at the Institute of Cancer Research at the Medical University of Vienna tested trabectedin on six different mesothelioma cell lines, 13 mesothelioma surgical specimens, and 2 non-malignant pleural tissue samples.
“Trabectedin exerted a dose-dependent cytotoxic effect in all malignant pleural mesothelioma cell cultures in vitro…,” writes study author Mir Alireza Hoda in the journal Molecular Cancer Therapy. “Non-malignant mesothelial cells were significantly less responsive.”
How Does Trabectedin Fight Mesothelioma?
One of the ways that trabectedin appears to help fight mesothelioma is by impacting cellular expression of bcl-2, a group of proteins that regulate cell death by either inducing or inhibiting apoptosis..
Bcl-2 levels in the treated mesothelioma cells decreased as the dose of trabectedin went up. The effect was even more pronounced when trabectedin was given along with experimental bcl-2-inhibiting drugs.
Trabectedin also did an even better job of killing mesothelioma cells when it was given along with cisplatin, a platinum-based chemotherapy drug that is routinely used in mesothelioma treatment.
Finally, the team tested trabectedin on peritoneal mesothelioma tumors from mice where it exhibited “significant antitumor activity”.
“Together, these data suggest that trabectedin exerts strong activity in malignant pleural mesothelioma and synergized with chemotherapy and experimental bcl-2 inhibitors in vitro,” concludes the article. “Thus, is represents a promising new therapeutic option for malignant pleural mesothelioma.”
Hoda, MA, et al, “Trabectedin is active against malignant pleural mesothelioma cell and xenograft models and synergizes with chemotherapy and bcl-2 inhibition in vitro”, August 10, 2016, Molecular Cancer Therapeutics, Epub ahead of print