TLDR

  • Mesothelioma, a rare asbestos-linked cancer, has poor survival rates and affects the lung lining
  • A trial led by Queen Mary University of London and The University of Western Australia developed ADI-PEG20, a drug that boosts Mesothelioma patient survival rates when used with chemotherapy
  • Published in JAMA Oncology, this study marks a major milestone, being the first successful chemo combination for Mesothelioma in 20 years
  • The treatment works by targeting cancer metabolism, specifically by reducing arginine levels in the blood stream, which is crucial for cancer cell growth
  • The success of this research offers hope for improved outcomes and a potential cure for Mesothelioma

Mesothelioma, a cancer often caused by asbestos exposure, is challenging due to its aggressiveness and low survival rates.

This asbestos-linked cancer affects the lining of the lungs, abdomen, or heart and is notoriously difficult to treat.

It can also impact other organs, making it a complex disease to treat. 

However, recent advancements in treatment have sparked hope for patients worldwide.

A pioneering clinical trial conducted by Queen Mary University of London and The University of Western Australia has led to the development of a groundbreaking drug known as ADI-PEG20.

The recently developed medication, ADI-PEG20 (pegargiminase), marks the first successful combination with chemotherapy in two decades.

The trial included patients from the UK, US, Australia, Italy, and Taiwan, overseen by Prof Peter Szlosarek at Queen Mary.

Patients underwent chemotherapy every three weeks for up to six cycles. 

Half of them received injections of the new drug, while the other half received a placebo over two years.

The study included 249 people with pleural Mesothelioma, a type of cancer that affects the lung lining. Their average age was 70.

Cancer
Cancer Cell

The ATOMIC-meso trial was carried out at 43 centres across five countries from 2017 to 2021.

Patients who received pegargiminase and chemotherapy survived for an average of 9.3 months, while those who had the placebo and chemotherapy survived for 7.7 months on average, as reported in JAMA Oncology.

The average duration of progression-free survival was 6.2 months for patients who received pegargiminase chemotherapy, compared to 5.6 months for those who received the placebo and chemotherapy.

Importantly, the treatment was well tolerated, with no new safety concerns for patients with asbestos-linked cancer.

This marks the first successful combination of chemotherapy with a drug targeting cancer metabolism developed for this disease in 20 years.

It follows Professor Szlosarek’s two-decade-long work, starting from his discovery that Mesothelioma cells lack a protein called ASS1, necessary for producing the amino acid arginine.

Utilizing this understanding, researchers developed the new drug, ADI-PEG20. It operates by reducing arginine levels in the bloodstream. 

Szlosarek expressed his excitement about the success of the research in depriving cancer cells of arginine.

He has been leading this research from its inception in the lab, and now, the new treatment, ADI-PEG20, is positively impacting patients with asbestos-linked cancer.

Dr Tayyaba Jiwani from Cancer Research UK, which, along with the biotechnology company Polaris Group, funded the research, emphasized the importance of discovery research. 

This type of research enables a deeper understanding of Mesothelioma biology, revealing vulnerabilities that can now be targeted with ADI-PEG20.

Liz Darlison, the chief executive of Mesothelioma UK charity, expressed pride in the UK Mesothelioma community, which includes doctors, nurses, patients, and families affected by the disease. 

She highlighted the significance of the ATOMIC trial, stating that it provides a crucial new treatment option and, most importantly, hope for individuals living with Mesothelioma.

We eagerly anticipate the widespread availability of this treatment as a standard option for all patients in the future.

The collaboration between international researchers emphasizes the global impact of this breakthrough, offering hope to individuals affected by asbestos-linked cancer.

Further research is necessary to confirm these findings, but the initial results emphasize the need for continued investment in research and development for complex medical conditions like Mesothelioma.

The scientific community eagerly anticipates more detailed insights into the mechanisms and long-term effects of ADI-PEG20, with the hope that it may emerge as a transformative therapy for asbestos-linked cancer.

This breakthrough offers hope for those with Mesothelioma, providing optimism for better outcomes and, ultimately, a cure for this challenging disease.

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