Scientists have made the biggest breakthrough in 20 years by developing a drug to treat mesothelioma, a notoriously difficult-to-treat cancer associated with asbestos.
Thousands of people around the world are diagnosed with the disease each year, which tends to affect the lungs and is primarily caused by exposure to asbestos in the workplace. It is highly aggressive and deadly, and cancer survival rates are among the worst in the world.
Now scientists have hailed the arrival of a new treatment as “absolutely amazing”, saying it should bring new hope to people with the disease and their families.
A new drug that cuts off a tumor's nutritional supply has quadrupled three-year survival rates in a five-country international trial led by Queen Mary University of London. The results were published in JAMA Oncology.
“This trial has changed the lives of mesothelioma patients, allowing us to live longer,” said one patient who benefited from the drug. The 80-year-old man, who asked to remain anonymous, won compensation from his former employer after being exposed to asbestos at a factory in the 1970s.
He was given four months to live, but thanks to the court case, he is still alive five years later. “I have five grandchildren and two great-grandchildren now, and I don't want to miss out on any of that,” he said.
Experts say this progress is important because mesothelioma has one of the lowest survival rates of cancer. The new drug ADI-PEG20 (pegalgiminase) is the first drug of its kind in 20 years to be successfully used in combination with chemotherapy.
The trial involved patients from the UK, US, Australia, Italy and Taiwan and was led by Professor Peter Slosalek from Queen Mary University. Each subject received up to six cycles of chemotherapy every three weeks. Half of the participants also received injections of the new drug, while the other half received a placebo for two years.
Among the patients included in the final analysis were 249 patients with pleural mesothelioma, which affects the lining of the lungs. Their average age was 70 years.
The study, known as the ATOMIC-meso trial, was conducted at 43 sites in five countries between 2017 and 2021. Patients who received pegalgiminase and chemotherapy lived an average of 9.3 months, compared with 7.7 months for those who received placebo and chemotherapy. Chemotherapy, according to the results published in JAMA Oncology.
The mean “progression-free survival” was 6.2 months for patients who received pegalgiminase chemotherapy, compared to 5.6 months for patients who received placebo and chemotherapy.
“In this pivotal randomized, placebo-controlled, phase 3 trial of 249 patients with pleural mesothelioma, pegalgiminase chemotherapy significantly prolonged median overall survival by 1.6 months compared to placebo chemotherapy. , quadrupled survival by 36 months,” the authors wrote. .
“Pegalgiminase-based chemotherapy was well tolerated and there were no new safety signs.”
This breakthrough follows 20 years of research by Szlosarek since he first discovered that mesothelioma cells lack a protein called ASS1, which allows cells to manufacture the amino acid arginine. .
This knowledge was used in the development of drugs. ADI-PEG20 works by depleting arginine levels in the bloodstream. For tumor cells that cannot produce their own arginine, this means their growth is stunted.
“It's really exciting to be able to do research on arginine starvation in cancer cells,” Slosalek said. “This discovery is something I have been championing from the beginning in our lab, and our new treatment, ADI-PEG20, is now improving the lives of patients affected by mesothelioma.”
Dr Tayyaba Jiwani, from Cancer Research UK, which co-funded the study with biotech company Polaris Group, said: ADI-PEG20”
Liz Darlison, chief executive of the charity Mesothelioma UK, said: “The UK mesothelioma community, including doctors, nurses, patients and families living with mesothelioma, is extremely proud of ATOMIC. This provides another much-needed treatment option and above all brings hope to people living with mesothelioma.
“We look forward to making this treatment available to all patients as a standard option in the future.”
