A new drug for rare cases of mesothelioma has just passed Phase II clinical trials in an Italian study. The drug showed a promising survival benefit in mesothelioma patients with biphasic and sarcomatoid cell types.

In the trial, 41.2 percent of patients for whom standard chemotherapy was ineffective, had no disease progression for three months.

Trabectedin is the drug’s name. Curiously, scientists derived the drug in 1969 from the sea squirt, a marine life form that functions as a type of filter. Trabectedin has treated ovarian and advanced soft tissue sarcomas. It’s applications in mesothelioma need more research, but upcoming clinical trials will include more participants.

Treating Biphasic and Sarcomatoid Mesothelioma

Biphasic and sarcomatoid mesothelioma are notoriously hard to treat. These cell types spread faster throughout the body than epithelioid mesothelioma. The epithelioid type is more common and less deadly because it spreads slower.

Sarcomatoid mesothelioma consists of cells that are more sickle shaped. This allows the cells to travel more freely through the blood and lymph systems. Biphasic mesothelioma is a mix of sarcomatoid and epithelioid cells.

There is no doubt that all mesothelioma cell types are hard to treat. But the rarity of biphasic and sarcomatoid patients has translated to less available research.

For now, treating these rare types of mesothelioma involves standard chemotherapy, which doesn’t always work.

Why Second-Line Treatment Is Important

Potentially effective second-line treatments involving drugs like trabectedin are rare.

Second-line treatment for mesothelioma is one of the next frontiers in improving survival. This is especially true for more aggressive biphasic and sarcomatoid types of mesothelioma.

The lack of available research surrounding rare mesothelioma cell types has led to limited treatment options. Sometimes standard treatment isn’t effective for biphasic and sarcomatoid patients doesn’t work. This is where second-line treatment comes in.

Without a second-line treatment, biphasic and sarcomatoid patients don’t have many options. But the results of this Phase II trial are a cause for hope.

“Mesothelioma patients usually do not respond to second-line treatments so the preliminary data we observed here is encouraging,” said Dr. Diego Luigi Cortinovis in a press release.

An effective second-line treatment for biphasic and sarcomatoid mesothelioma patients would significantly improve the length of survival across the board. Unfortunately, biphasic and sarcomatoid types have the poorest prognoses. But trabectedin could grant these patients several more months with loved ones.

Looking Toward the Future of Biphasic/Sarcomatoid Treatment

Clinical trials are a valuable source of treatment for any mesothelioma patient. However, biphasic and sarcomatoid mesothelioma patients often have more to gain from clinical trials. These trials vastly expand treatment options for bipahsic and sarcomatoid patients.

Although the current trials are taking place in Italy, the successful results are still a cause for the hope. Inventive clinical trials like this could change the future of mesothelioma treatment.

As clinical trials for trabectedin advance to Phase III, more evidence will emerge about the drug’s potential.

Ongoing Clinical Trials in the United States

The clinical trial of trabectedin only offers a direct benefit for biphasic and sarcomatoid patients willing to travel to Italy. Therefore, it’s worth mentioning some trials currently taking place in the U.S.

Two notable trials include:

  • Pembrolizumab – This Phase II trial is currently testing the effects of pembrolizumab, an immunotherapy drug. It works by activating the immune system to fight mesothelioma cells. The University of Chicago Cancer Center is sponsoring this trial.
  • Standard chemotherapy with cediranib – Participants in this trial get standard chemotherapy. They also get a drug called cediranib or a placebo. Cediranib stops the growth of tumor blood vessels. Over 200 cancer centers are participating in this trial.

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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.