| | | | |

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

Similar Posts

Doctors Describe "Concrete Therapeutic Approach" for Mesothelioma
| |

Doctors Describe "Concrete Therapeutic Approach" for Mesothelioma

ByAlex Strauss

A team of medical researchers in Italy have achieved what they are calling “excellent” tumor control and survival results in malignant pleural mesothelioma patients using a combination of surgery, chemotherapy, and radiotherapy. Caused by exposure to asbestos, mesothelioma typically spreads quickly across the lung-encasing membrane called the pleura. There is no known cure but treatments are improving. In the current prospective study, 20 malignant pleural mesothelioma patients underwent radical pleurectomy/decortication followed by high doses of radiation. After surgeons removed as much of the visible mesothelioma tumor and surrounding tissue as possible, patients received 50Gy of radiation to the effected side of their chest, delivered in 25 fractions. Regions of particular concern for mesothelioma regrowth got an extra radiation “boost” to…

Does Radiotherapy Reduce Mesothelioma Pain?
| |

Does Radiotherapy Reduce Mesothelioma Pain?

ByAlex Strauss

A new study says there is not enough evidence to support the use of radiotherapy for the treatment of pain associated with malignant pleural mesothelioma. Researchers at the University of Edinburgh in Scotland reviewed a range of past studies on mesothelioma pain and radiotherapy by searching databases that date back as far as 1974. To be eligible to be included in their review, the study had to focus on malignant pleural mesothelioma and radiotherapy given “with the intent of improving pain”. The study also had to report doses and fractionation of the radiotherapy and how the pain responded. In all, the researchers found eight studies on mesothelioma pain and radiotherapy that met the criteria. Two of the studies were prospective…

Ape Virus Shrinks Mesothelioma Tumors in Lab
|

Ape Virus Shrinks Mesothelioma Tumors in Lab

ByAlex Strauss

A virus that causes leukemia in gibbon apes may have the power to help fight malignant mesothelioma in people. Gibbon ape leukemia virus (GALV) has been tested for years as a viral vector, a carrier of therapeutic genetic information, in the treatment of various human illnesses, including cancer. A new study in Japan compared GALV with a leukemia virus derived from mice to see which carrier communicated most efficiently with mesothelioma cells. While both types of viruses replicated in most of the mesothelioma cell lines tested, the mouse-derived virus was not effective in a mesothelioma cell line called ACC-MESO-1. In this cell line, only the GALV spread efficiently both in culture and in mice that had been given human mesothelioma…

Radiotherapy for Mesothelioma: Better But Still Limited
| |

Radiotherapy for Mesothelioma: Better But Still Limited

ByAlex Strauss

A form of highly-targeted radiation therapy for mesothelioma is better than it used to be, but is still risky. That is the message of a recent article on intensity-modulated radiation therapy (IMRT) in Seminars in Thoracic and Cardiovascular Surgery. Author Kenneth E. Rosenzweig, MD, a Radiation Oncologist with Mount Sinai Hospital in New York, reviewed recent studies on IMRT and mesothelioma. He concludes that, while the “troubling toxicity” associated with IMRT when it was first introduced has not been entirely eliminated, the fact that clinicians now have more experience with it is making a positive difference for mesothelioma patients. Before targeted therapies like IMRT were available, high-dose radiation was not usually a feasible option for mesothelioma since the irregular shape…

A Second-Line Option for Mesothelioma?
| |

A Second-Line Option for Mesothelioma?

ByAlex Strauss

Although survival was not significantly extended, the chemotherapy drug vinorelbine might be a treatment option for mesothelioma patients whose cancer has returned after first-line chemotherapy with pemetrexed. A new study on vinorelbine as a second-line treatment finds that the drug is “moderately active” in mesothelioma patients who were initially treated with pemetrexed-based chemotherapy. Pemetrexed (Alimta), along with a platinum-based drug like cisplatin, is the primary first-line drug therapy for mesothelioma. But vinorelbine is gaining attention as a possible option for mesothelioma, in part because it is available in a less expensive generic form. In “Vinorelbine in pemetrexed-pretreated patients with malignant pleural mesothelioma”, the Italian authors detail the results of their study on 59 patients with unresectable pleural mesothelioma.  These patients…

Repeat HIPEC Improves Mesothelioma Survival
| |

Repeat HIPEC Improves Mesothelioma Survival

ByAlex Strauss

If one cytoreductive surgery and HIPEC procedure for mesothelioma is good, subsequent treatments may be even better. That is the central message of research conducted at the Moffitt Cancer Center in Florida. The study’s aim was to assess overall survival among peritoneal mesothelioma patients who had not just one, but two or more rounds of heated intraperitoneal chemotherapy (HIPEC) after cytoreductive surgery. The cytoreduction/HIPEC approach has become popular for peritoneal mesothelioma, a treatment-resistant cancer of abdominal membranes caused by asbestos. Cytoreductive surgery involves removing as much of the mesothelioma tumor as possible from the abdomen. Because the shape and spreading pattern of mesothelioma tumors make complete cytoreduction difficult, the surgery is often followed by a rinse with a heated solution…