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Introduction - Emerging Treatments

Research is helping us to understand how new drugs may be able to improve the response of mesothelioma to chemotherapy. It is hoped that continued research will provide new options for the treatment of mesothelioma in the future. Research can be scientific (conducted in the laboratory) or medical (conducted through clinical trials involving people). New drugs are tested in the laboratory first and if the results are promising they are then tested on people in clinical trials.

Please find below brief information regarding scientific and medical research into new treatments for mesothelioma. Much of this research is scientific and being carried out in the laboratory. The medical research described is being carried out in early clinical trials, mainly outside the UK. The results of research are shared internationally through medical publications, conferences and educational meetings.

Further information about Mesothelioma clinical trials can be found by following the link below. Please note this is the National Institutes of Health's website in the US and includes trial information for trials being undertaken by the National Cancer Institute in the USA and other countries including the UK.

Clinical Trials.Gov - US National Institutes of Health

Proteosome Inhibitors

Proteosome eliminates old proteins in normal cells. Drugs called proteosome inhibitors interfere with how proteosome works, and cause cells to die. Cancer cells are much more sensitive to the effects of the proteosome inhibitors than normal cells, therefore cancer cells will be destroyed more readily than normal cells.

An International Research Trial to investigate this is now open in the Republic of Ireland, Netherlands and Belgium and is due to open in the UK this year. This trial explores the activity of a Proteosome Inhibitor called Velcade (also known as bortezomib), currently used to treat myeloma (cancer of the bone marrow). Velcade holds back the proteosome. A second European Research Trial is now enrolling patients and exploring the combination of Velcade and Cisplatin chemotherapy.

New Blood Vessel Growth

In order to grow, malignant tumours (including Mesothelioma), need to grow new blood vessels. The growth of new blood vessels is called angiogenesis.

A new family of drugs called angiogenesis inhibitors target the development of new blood vessels to slow down their development and, therefore, the growth of malignant tumours. These drugs have been shown to be effective in treating other cancers, such as lung cancer.

New blood vessel growth (angiogenesis) is promoted by specialised “growth factors”, one of which is called Vascular Endothelial Growth Factor or VEGF. Research is underway to investigate the activity of drugs that inhibit the action of VEGF in Mesothelioma including PTK787, AZD2171 and Bevacizumab.

Growth Factors

Drugs to Inhibit Growth Factors

Cancer cells require growth factors for survival. Recently it has been discovered that blocking such factors may slow down the growth of malignant tumours. Research has found that Mesothelioma cells respond to EGF and VEGF. Blocking the response to both EGF and VEGF may halt or reverse Mesothelioma growth and this is being explored in an early clinical trial in the USA.

Drugs to Activate Cell Suicide Proteins

Cancer cells contain a family of proteins on their surface called death receptors that when activated, kill the cancer cell. Very early clinical research will be undertaken to see if Mesothelioma cancer cells will respond to the activation of the death receptors.

Enabling Genes to Work Again

When a person has cancer some genes are prevented from working. When this happens it may result in uncontrolled cell growth and, thus, tumour growth. Histone Deacetylase Inhibition (HDACi) is a new way of enabling these genes to work again. In mesothelioma, research is both ongoing and planned in an effort to identify whether the use of HDACi is effective in preventing tumour growth and whether the use of an HDACi will also increase the effectiveness of other chemotherapy drug treatments on mesothelioma tumours. For example, the drug SAHA (suberoylanilide hydroxamic acid) is a Histone Deacetylase Inhibitor (HDACi) and is currently being used in mesothelioma research.