Maintenance Treatment With Defactinib
Type: Pleural Mesothelioma
Defactinib is one of the most recently developed drugs used to fight mesothelioma. The stem cell-targeting drug has the potential to keep mesothelioma from returning after standard treatments.
Killing Mesothelioma Cancer Stem Cells
This trial was terminated and is no longer recruiting. The trial, alternately called COMMAND (Control of Mesothelioma with MAiNtenance Defactinib), evaluated the use of the new drug (defactinib) which targets mesothelioma stem cells. The purpose of the treatment is to prevent tumors from reappearing after the first rounds of chemotherapy with Alimta, cisplatin and other treatments. During this phase II trial, defactinib was unable to to prove effective enough to continue enrolling patients.
What to Expect
- Defactinib (VS-6063) – This is an experimental, orally administered drug. It is the only drug being evaluated in this clinical trial. Participants in the trial will take a 400 mg pill twice a day for as long as their disease does not progress.
- Maintenance Therapy – After cancer patients have their first rounds of treatment, whether that is surgery or chemotherapy, the next step is to prevent the cancer from spreading. This is the goal of defactinib.
If the trial had proven successful, COMMAND would have been the first maintenance treatment available to mesothelioma patients. Although it isn’t designed to kill off mesothelioma tumors, it may have allowed patients to live much longer by managing their disease. Defactinib is still being tested for other purposes.
Connect with Clinical Trials Now
Clinical Trials Can Provide:
- Exclusive access to promising new procedures.
- One-on-one care from leading mesothelioma specialists.
- Alternative options for patients who have exhausted traditional treatments.
How It Works
Treatment for mesothelioma is still far behind the treatments available for more common cancers. The use of a combination of the chemotherapy drugs Alimta and cisplatin has made a huge impact in the treatment of mesothelioma. However, mesothelioma tumors tend to come back in a more aggressive manner even after successful rounds of chemotherapy. Adding to the challenge is that these new tumors often develop a resistance to previously used chemotherapy drugs.
Research conducted by Dr. Robert Weinberg found that mesothelioma often grows back after being treated with chemotherapy because the cancerous stem cells remain after treatment. Furthermore, these stem cells may be attributed to the disease’s acquired resistance to chemotherapy.
Defactinib is designed to block the signaling pathways that deliver nutrients to mesothelioma stem cells and starve them. The goal is to maintain the success of the initial treatments by preventing mesothelioma from growing back and spreading.
Who Is This Trial For?
This clinical trial is for pleural mesothelioma patients who wish to outlive their prognosis. There is no guarantee that this trial will work, but it could prevent tumors from growing back and metastasizing.
To be eligible, participants must:
- Have received only one regimen of chemotherapy
- Wait 6 weeks after last chemotherapy treatment
- Wait at least 28 days after major surgery
- Have a prognosis greater than 3 months
Getting Enrolled in This Trial
This trial is no longer recruiting. However, defactinib is still being tested for other uses, including mesothelioma treatment. If you are interested in participating in clinical trials, or simply learning more about them, we can help. Our team of patient advocates are experienced in helping patients enroll in trials that are likely to provide them with the greatest survival benefit. Get connected with clinical trials today.
The COMMAND trial of defactinib has study locations all around the world. There are studies taking place throughout North America, Europe and all the way in Japan. Below are the locations for the study in the United States.
Principal Investigator: Dr. Evan Alley
Dr. Alley is an experienced medical oncologist leading the defactinib trial at Abramson Cancer Center. Standard treatment for mesothelioma only has limited effects currently, which is why Dr. Alley has said, “That’s why we’re looking for other better therapies.” Abramson is known for its extensive team of mesothelioma specialists as well as its success at treating the disease.
Principal Investigator: Dr. Hedy Kindler
Dr. Kindler sees more than 100 mesothelioma patients per year at the University of Chicago. Her experience has led her to understand that mesothelioma patients need far better treatments and that research into drugs like defactinib is the way to get there. “We need better drugs,” said Dr. Kindler. “We need more preclinical investigations. We need better designed trials.” The COMMAND trial of defactinib takes this all into account.
Principal Investigator: Dr. Marjorie Zauderer
Sloan-Kettering has one of the best mesothelioma teams in the country. Dr. Zauderer is an assistant physician with years of experience treating mesothelioma patients and researching the disease. She has conducted research in radiation and chemotherapy for mesothelioma, but her strongest interest is in novel treatments like defactinib.
Principal Investigator: Dr. James Stevenson
Dr. Stevenson is the chief of medical oncology at the Cleveland Clinic. He was formerly a part of the mesothelioma program at the Abramson Cancer Center, which is also conducting research on defactinib. He formed the mesothelioma program in Cleveland in part because of his belief that it’s beneficial to have more experienced treatment centers across the country for patients.
Principal Investigator: Dr. Julie Brahmer
Dr. Brahmer is an active clinical research investigator for mesothelioma. She has also placed a lot of importance on the physical and emotional quality of life her patients experience. Dr. Brahmer is also directing a clinical trial to uncover possible genetic causes of mesothelioma.
UT Southwestern Simmons Cancer Center
Principal Investigator: Dr. Jonathan Dowell
Dr. Dowell is another specialist active in mesothelioma research. He is the director of the mesothelioma program at UT Soutwestern in Dallas. Dr. Dowell has studied a multitude of novel therapies in mesothelioma. Defactinib is one of his most promising trials yet.