TREATMENT: Study Uncovers Drug Combination for Sarcomatoid Mesothelioma
Researchers in Spain have discovered a drug combination showing potential in treating the most difficult-to-treat type of malignant mesothelioma.
Selumetinib and AZD8186, already being studied separately in clinical trials for other cancers, displayed efficacy when used in combination on mesothelioma of the sarcomatoid cell type.
Researchers at the Spanish National Cancer Research Centre made the discovery during their study using mice models and human tumor cells in the laboratory.
“The findings, we hope, are relevant,” Dr. Paco Real, who led the study, told The Mesothelioma Center at Asbestos.com. “We don’t know yet how important they are. We’re still being cautious in our predictions. Curing mice is different than curing patients.”
Cancer Research published the findings January 7 Titled: Combined MEK and PI3K/p110b inhibition as a novel targeted therapy for malignant mesothelioma displaying sarcomatoid features
Pivoting from Bladder Cancer to Mesothelioma
Researchers originally were testing the drug combination for bladder cancer while focusing on two particular tumor suppressor genes and how they were being inactivated.
A mid-study switch, though, drew them to the even more aggressive sarcomatoid mesothelioma.
They discovered the drugs in combination reduced the proliferative and invasive capacities of mesothelioma by targeting similar molecular pathways.
Doctors are using Selumetinib, which is licensed to AstraZeneca, in clinical trials involving certain non-small cell lung cancers and thyroid cancer.
The U.S. Food and Drug Administration in 2019 granted Breakthrough Therapy Designation for Selumetinib’s use with a rare and incurable genetic condition found in young children.
AZD8186 also is being studied in numerous clinical trials involving certain types of prostate, breast and non-small cell lung cancers.
“We found a drug combination that was effective in both mice and human cell lines,” Real said. “We chose drugs that already were being tested for other tumors, so their toxicity is well understood. These are two compounds that are by no means new. They can be used in clinical trials soon.”
The research also identified specific molecular markers on the tumor cells for predictive therapy response, which could be used for clinical trial patient selection.
“At this point, it’s impossible to predict exactly how important our findings are,” he said. “It depends on the benefit the patients will see. We know we can increase the lifespan of a mouse. We need a clinical trial to see where it goes now. Hopefully, the impact will be significant.”
Women and Mesothelioma: New Statistics Released
Mesothelioma is primarily considered a “male cancer.” This characterization is due to the disease’s origin (exposure to asbestos) and situations where that origin could occur (blue-collar occupational work).
Since mesothelioma mostly affects men, most of the studies and statistics revolve around this gender. However, females can — and often do — develop this cancer. Therefore, more research into how this cancer affects women is needed.
Duke University Hospital researchers recently published a report focusing solely on mesothelioma cases involving women. This study, which was published in the American Journal of Surgical Pathology, details which form of mesothelioma most often affects this gender.
Which Type of Mesothelioma Do Women Get?
The Duke University research team studied 354 cases of malignant mesothelioma in women. Of them, around 78% of them were pleural mesothelioma and 22% were peritoneal mesothelioma.
Pleural mesothelioma forms when asbestos fibers reach the pleura, which is a cavity separating the lungs and chest wall. Peritoneal mesothelioma forms when asbestos dust reaches the peritoneum, which is a thin membrane covering the abdomen.
This breakdown is surprisingly consistent with that of males (around 80% for pleural and 20% for peritoneal). The shock is due to previous studies showing women as more likely than men to get peritoneal mesothelioma.
In a Lung Cancer International study from 2017, males comprised 81% of all pleural mesothelioma cases. However, the split was close to 50-50 for peritoneal mesothelioma cases.
The team at Duke University did mention in their report a “trend toward … peritoneal location” but added it “did not reach statistical significance.”
The study also found that women mostly get the epithelioid cellular variation of mesothelioma. In fact, according to the study’s results, they are more likely than men to get this type of the cancer. This news is fortunate for women as epithelioid mesothelioma is more easily treated than the other two cellular types: sarcomatoid and biphasic.
Exposure to asbestos is the only way people can develop mesothelioma, and this substance was used for commercial purposes through most of the 20th century. The prevalence of asbestos in numerous occupations put not only the workers but their wives, daughters, mothers and other female loved ones in danger.