Breakthrough involving Addenbrooke’s is first for 15 years in treatment of asbestos-related cancer

A breakthrough in the treatment of a rare and aggressive cancer associated with asbestos has been made at the culmination of 20 years of research.

An Addenbrooke’s consultant clinical oncologist was involved in the international team, led by Queen Mary University of London, studying malignant pleural mesothelioma (MPM).

It affects the lining of the lungs and is usually treated with potent chemotherapy drugs, but these are rarely able to stop it.

But a trial found that a treatment that combines a new drug, ADI-PEG20, with traditional chemotherapy increases the median survival of participants by 1.6 months, and quadrupled the survival at 36 months, compared to placebo plus chemotherapy.

That is significant because MPM has one of the lowest five-year survival rates of any solid cancer, at just five to 10 per cent.

And the approach is the first successful new type of chemotherapy developed for the disease in 15 years.

Study lead Prof Peter Szlosarek, at Queen Mary’s Barts Cancer Institute, said “We found the patients who had the drug lived an average of two months longer. Interestingly, there was a group of patients in the study who’ve survived over three years now, which is very encouraging and we are looking at that particular group in more detail.”

The study, sponsored by Polaris Pharmaceuticals and published by the American Medical Association journal JAMA Oncology, featured 249 patients at dozens of hospitals all over the world, including six at Addenbrooke’s over a period of three years.

The ADI-PEG20 drug depletes levels of an amino acid, called arginine, in the bloodstream, which effectively starves the tumour cells.

It comes after two decades of research at the Barts Cancer Institute, which began with a discovery by Prof Szlosarek that malignant mesothelioma cells lack a protein called ASS1. This protein enables cells to manufacture their own arginine.

Since then, he and his team have since dedicated their efforts to using this finding to create an effective treatment for patients with MPM.

And the drug may be of use in the treatment of other types of cancer, with further studies planned to assess it in patients who have other cancers dependent on arginine.

Dr Gilligan is a member of the British Thoracic Oncology Group (BTOG), senior medical editor at Macmillan, a trustee of the Roy Castle Lung Cancer Foundation, and a consultant oncologist at Royal Papworth Hospital.

He said: “As a recognised world leader in cancer research Addenbrooke’s was delighted to support this study, which is a significant step forward in the treatment of MPM and potentially other difficult to treat cancers.”

Visit https://jamanetwork.com/journals/jamaoncology/fullarticle/2815000 to read the paper.