On their own, individual therapies aren’t as effective at slowing or stopping mesothelioma. The answer seems to be teaming multiple methods up as a combined force.
The combination of ramucirumab, an immunotherapy drug, with chemotherapy showed survival benefit in a recent phase 2 clinical trial for pleural mesothelioma. The study, conducted in Italy, was presented at the annual American Society of Clinical Oncology conference. This meeting was held virtually due to the ongoing COVID-19 coronavirus pandemic.
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Survival for Ramucirumab and Gemcitabine in Pleural Mesothelioma
Investigators paired ramucirumab with the chemotherapy drug gemcitabine and compared this combination with gemcitabine on its own. The pairing netted better survival outcomes than just chemotherapy.
The double-blind clinical study included up to 161 participants. They were split into two groups: one receiving ramucirumab and gemcitabine; and the other receiving gemcitabine.
All participants received the same dosage of gemcitabine, which was administered twice during a three-week cycle. The ramucirumab group received the mesothelioma immunotherapy on the first day of the period.
Ramucirumab nearly doubled the survival effect of chemotherapy:
- The 80 patients who received ramucirumab had a median overall survival of almost 14 months.
- The 81 patients who received just gemcitabine had a median survival of 7.5 months.
- The ramucirumab group had a median progression-free survival (PFS) of 6.2 months, and the chemotherapy-only group had a median PFS of 3.3 months.
More data showed the benefit of ramucirumab:
- The ramucirumab-gemcitabine group had a six-month survival rate of 74.7% and a one-year survival rate of 56.5%.
- The gemcitabine-only group had six-month and one-year survival rates of 63.9% and 33.9%, respectively.
“Ramucirumab plus gemcitabine combination can represent a new option in the second-line treatment of (malignant pleural mesothelioma),” the presenter said during the conference.
How Does Ramucirumab Help With Mesothelioma?
Ramucirumab is an anti-VEGF drug that helps slow down the growth and spread of mesothelioma tumors. VEGF is an acronym for “vascular endothelial growth factor.”
VEGF is a protein commonly expressed in mesothelioma tumors. It signals for mesothelioma cells to create new blood vessels, a process called angiogenesis.
All cells need oxygen and blood to survive. Diseased cells use angiogenesis to supply themselves with oxygen-rich blood.
In addition to cancer cells thriving, VEGF-caused angiogenesis can have another negative effect. The remaining healthy cells are blocked from receiving blood and can die at a faster rate than usual.
Ramucirumab blocks the creation of blood vessels and deprives mesothelioma cells of nutrients. They essentially suffocate and die, with the chemotherapy drugs helping by attacking the weakened cells.
Ramucirumab is a focus of another mesothelioma study that pairs it with the immunotherapy drug nivolumab.
Sources & Author
- Ramucirumab–gemcitabine encouraging in second-line malignant pleural mesothelioma. Medwire News. Retrieved from:
https://www.medwirenews.com/oncology/respiratory/ramucirumab-gemcitabine-malignant-pleural-mesothelioma/18096212. Accessed: 06/24/2020.
- A Double Blind, Placebo Controlled, Randomized Phase II Study Evaluating Gemcitabine With or Without Ramucirumab, for II Line Treatment MPM (RAMES). Clinicaltrials.gov. Retrieved from:
https://clinicaltrials.gov/ct2/show/NCT03560973. Accessed: 06/24/2020.
Sources & Author