There is a fierce new opponent in the fight against advanced pleural mesothelioma. The novel drug, NGR-hTNF, has shown encouraging results after a Phase III clinical trial testing the drug’s impact on late stage mesothelioma. The recently released results of the study showed a 40 percent improvement in the survival time of advanced stage mesothelioma patients.

The drug was developed by the Italian pharmaceutical company MolMed. NGR-hTNF slows down the growth and metastasis of cancerous tumors, making it possible for late stage patients to live longer with the disease, welcome news for Stage 3 and Stage 4 patients.

“For the first time in malignant pleural mesothelioma a highly significant clinical benefit was achieved in a large subpopulation with the worst prognosis, represented by patients…rapidly progressing after first line treatment,” said MolMed CEO Claudio Borgman.

NGR-hTNF has been primarily used in patients with relapsed mesothelioma—patients who have had previous treatment only to have tumors reappear. It has also been studied in combination with chemotherapy for various cancers.

How NGR-hTNF Prevents Mesothelioma Growth

NGR-hTNF is a novel therapeutic agent that aims to inhibit the production of blood vessels in the tumor, thereby stopping it from getting bigger. Blood vessels are the primary fuel source for mesothelioma tumors, providing oxygen and nutrients that allow the tumor to thrive.

Angiogenesis is simply the scientific name for the process of new blood vessels growing. Without angiogenesis, tumors do not grow or spread; this drug is aiming to cut off the metastasis of mesothelioma.

Angiogenesis (n) – the formation of new blood vessels

Angiogenesis normally occurs when signaling molecules bind to healthy cell receptors in the body, cuing the cell to develop more blood vessel cells. This is the same process that occurs when a cut or wound heals.

The introduction of an angiogenesis inhibitor causes the signaling molecules to bind to the drug instead of to cells that are essential to blood vessel production.

When mesothelioma develops, however, these signaling molecules also bind with the cancerous cell receptors, which stimulates the growth of blood vessels within the tumor. NGR-hTNF is specifically designed to stop the growth of blood vessels produced by the mesothelioma tumor.

This is where the name of the drug comes from. “NGR” is a peptide that binds to the molecules that signal blood vessel growth. “hTNF” (human tumor necrosis factor) is an anti-tumor agent binded to NGR, which essentially brings hTNF along for the ride.

Benefit for Late Stage Mesothelioma Patients

Angiogenesis drugs like NGR-hTNF may only stop or slow down the growth of mesothelioma, not reverse it. Although this drug wouldn’t kill mesothelioma cells, it could lead to the management of mesothelioma, which could drastically increase survival times. In part, the life expectancy of mesothelioma patients is short because there is no effective means of slowing down the growth of the disease.

Drugs that focus on the maintenance of mesothelioma hold the most potential for late stage mesothelioma patients.

There are fewer treatment options for patients as their disease progresses, but if a successful angiogenesis drug is found, late stage patients could live longer with their disease.

This specific clinical trial only tested NGR-hTNF as a single agent, meaning it was the only treatment given to patients at the time. This makes it clear that the drug has a significant clinical effect on increasing survival times by preventing metastasis.

The Future of Angiogenesis-Inhibiting Drugs

Angiogenesis drugs have been tested before in mesothelioma but to little or no avail. Avastin (bevacizumab) is one of the world’s most popular angiogenesis-inhibiting drugs, but hasn’t proven to be very successful with mesothelioma patients.

NGR-hTNF, however, could become a breakaway drug for relapsed and late stage patients as well as those who have finished their first rounds of treatment. The drug has been studied in a variety of clinical trials in the past for different forms of non-small cell lung cancers. In fact, NGR-hTNF is still being studied in several clinical trials currently underway.

One study is testing the efficacy of the drug in combination with the chemotherapy drug doxorubicin in patients with soft-tissue sarcomas. Hopefully, these studies will shed more light on the drug’s potential for mesothelioma patients.

The next step in the development of NGR-hTNF is Phase IV trials in which patients would be able to receive the drug from their own physician. This is a cause for hope for all mesothelioma patients as this demonstrates real progress toward the long-term management of mesothelioma and a longer life for patients.

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    About the Writer, Andrew Devine

    Andrew Devine is a contributing writer for Mesothelioma Guide. He has developed an interest in educating patients and their families on everything from new treatments to what to expect after diagnosis.