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A Phase II Trial of Tetrathiomolybdate After Surgery for Malignant Mesothelioma: Final Results

Friday, August 15, 2008

Source: The Annals of Thoracic Surgery

The development of novel therapeutic techniques is a major focus of contemporary mesothelioma research. Due to the disease’s uncanny resistance to conventional treatments, mesothelioma specialists and other research scientists are actively exploring new treatment strategies for this asbestos-caused disease. Their goal is to reverse the historic difficulties in fighting the disease by developing therapies that bring the same life-saving efficacy to patients with pleural mesothelioma and peritoneal mesothelioma (as well as patients with the rarer forms of the disease) that modern medicine has brought to patients with other forms of cancer.

Overview of the Study

One of the new therapeutic strategies under investigation for mesothelioma patients is the disruption of angiogenesis, the process by which new blood vessels are formed from pre-existing vessels. Angiogenesis is an important process for many of the body’s essential functions. For example, angiogenesis is necessary for any healing involving tissue damage because the development of replacement tissues require the generation of new blood vessels to continue their growth. However, angiogenesis is also a significant factor in the development of cancer. Tumors also need a fresh supply of blood to fuel their growth, so the malignancy co-opts the angiogenic process for its own stimulation. Contemporary research into the biochemical foundations of mesothelioma suggests that angiogenesis is especially important for the development of this malignancy, so a number of researchers are now investigating the use of anti-angiogenic treatments for mesothelioma patients.

Therapies targeting angiogenesis represent a growing frontier of cancer treatment. One such therapy that is currently being investigated for the treatment of multiple cancers is the administration of a copper-depleting agent to disrupt angiogenesis. Research has shown that angiogenesis requires the consumption of copper for its complete expression, so the theory behind the use of copper-depleting agents is that angiogenesis will falter if there isn’t enough copper to consume.

In light of this knowledge, researchers from some of the most well-known mesothelioma clinics conducted a feasibility study on the use of a copper-depleting agent for the treatment of mesothelioma and have recently published very exciting results.

Results

The researchers investigated the use of the copper-depleting agent tetrathiomolybdate in mesothelioma patients following surgery. 30 patients were enrolled in the study and their results were compared to a cohort of 164 patients the researchers had previously studied after surgery.

The study reports that median survival for all patients was 23 months and the median time to progression was 12 months. When the numbers were broken down by stage, Stage I and Stage II patients demonstrated a median survival of 41 months and time to progression of 20 months. Stage III patients had a median survival of 15 months and time to progression of 7 months.

Conclusion

These are truly excellent results as compared to the historical efficacy of most mesotheloima treatments, where median survival is less than 16 months for most patient groups.The authors found that the procedure was generally well-tolerated and quite effective. Though they were quick to qualify their results as limited by the small sample size and nature of the study itself, they also felt that more extensive studies should be conducted because their results compared very favorably to previous studies. Much more needs to be learned about copper-depleting treatments before they could become standard, but if the results of this study hold up, it represents a significant advance in our ability to treat patients with mesothelioma.

Labels: mesothelioma, treatments

posted by Belluck & Fox at 4:23 PM
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