Clapper, Patti, Schweizer and Mason

For years doctors have advocated multi-modal treatments for patients suffering from mesothelioma.  This deadly cancer is caused by exposure to asbestos, has no cure, and is very aggressive -- patients typically have just months to live after a diagnosis.  Therefore, any research that sheds new light on the effectiveness of individual or combined treatments sparks hope in the mesothelioma community.  But not all studies produce the type of results mesothelioma patients and their families are hoping for.

A new study whose results were published in Lancet examines the effectiveness of treatments which include the common anti-cancer drug Erlotinib (a tyrosine-kinase inhibitor) in addition to Bevacizumab (a drug that blocks angiogenesis – the growth of new blood cells.)  It was the hope of researchers that by combining these two drugs that they could inhibit the growth of cancerous tumors and prolong the longevity and quality of life for lung cancer and mesothelioma victims. 

Bevacizumab and erlotinib both target tumor growth but in different manners.  While one prevents the growth of new blood vessels, thereby starving the tumor of nutrients, the other targets the epidermal growth factor receptor within the cancerous cells.  Previous Phase I and Phase II trials had shown results that looked promising and warranted a Phase III test.  The drugs, it was hoped, would work in tandem without increased risk to the patient. 

Patients were recruited into the trial from 177 study sites in 12 countries and randomly allocated in two groups:  one received erlotinib alone; the other receiving both drugs.  The Phase III trial was conducted as a double-blind placebo test and all participants had cancers that failed to respond to standard first-line chemotherapy.

The average survival rate for mesothelioma patients within this trial was only three months.  In that time doctors could find no discernable difference in the lifespan of participants from either group though progression-free survival (zero or little tumor growth) seemed to be longer in the bevacizumab group. 

The risk factor of the combined treatment proved to be slightly higher with 130 of the study’s experimental participants having adverse reactions, including two extremely serious thromboembolic events –blood clots in the bloodstream, as opposed to only 114 in the group assigned a single medicine.

Though the results were less than positive, scientists will continue to examine multi-modal treatment methods in hopes that they can find the “magic bullet” that will stop mesothelioma in its tracks and, perhaps, even reverse the effects of this deadly cancer.