Clapper, Patti, Schweizer and Mason

Standard frontline therapies for mesothelioma, such as chemotherapy, surgery and radiotherapy, have not had much effect on increasing survival times or improving quality of life.  Mesothelioma is a malignancy caused primarily by exposure to asbestos that begins in the lining of the internal organs of the body.  Because of the lack of tumor response to conventional therapies, research into alternatives is continually investigating more effective interventions.

One alternative therapy that continues to show promise and superiority to standard chemotherapy for patients diagnosed with non-small cell lung cancer (NSCLC) with mutations in the epidermal growth factor receptor (EGFR) gene has been the use of gefitinib.   Gefitinib is a drug that acts as a tyrosine kinase (TKIs) inhibitor of EGFR.  When EFGR activity can be altered it can interrupt the development of mesothelioma tumors and further growth of malignant cells.

Three large clinical trials have all confirmed the efficacy of Gefitinib:

• IPASS (IRESSA Pan-Asia Study),
• INTEREST (Iressa NSCLC Trial Evaluating Response and Survival Versus Taxotere), and
• SATURN

All three studies confirmed that gefitinib activated cell death and improved median survival times and identified patients who had an increased number of EGFR mutations as benefitting the most from this line of treatment versus chemotherapy.

The studies further showed that side effects were less severe than traditional frontline therapies.    Furthermore, many patients with mesothelioma have a high resistance to standard drugs used in chemotherapy but not so with gefitinib.  Researchers will continue to investigate the use of this drug, looking for insights into the intercellular mechanism involved in an attempt to broaden their understanding of mesothelioma and improve intervention and delivery methods.