Professor Dean Fennell
University of Leicester
At last action is being taken to speed up the search in treatments for mesothelioma, a fatal cancer caused by asbestos.
For years mesothelioma has been largely ignored — despite being what Liz Darlison calls, “a public health disaster”.
Darlison, a Macmillan Nurse consultant with Mesothelioma UK, a charity that gives information and support, says: “The UK has the world’s highest incidence of mesothelioma, with 2,500 new cases diagnosed annually and rising. Half will die within the year — and yet there has been no published research into chemotherapy for the disease since 2007.”
Professor Dean Fennell, involved in clinical trails of new therapies for mesothelioma at the University of Leicester, says: “Researchers are meeting now to talk about accelerating treatment of mesothelioma. It’s an international emergency.”
90% of cases are caused by exposure to asbestos
Darlison says: “Anyone born before asbestos was banned in the UK in the 1990s is at risk because asbestos was used so widely. Our environment is riddled with it. It is still used elsewhere so the global incidence of mesothelioma could rise enormously.”
Mesothelioma is a cancer affecting the membrane of the lining the lungs. Symptoms include significant and distressing breathlessness, pain, loss of weight and energy.
Standard treatment involves chemotherapy with a combination of medication, but toxicity limits its use. However, the new COMMAND clinical trial will test the use of a new type of medication as a maintenance therapy to treat pleural mesothelioma (the most common form). The new drug prevents mesothelioma cancer stem cells from dividing and growing. These cells are an underlying cause of cancer recurrence and our inability to cure malignancy.
Recruitment is underway now in the UK and overseas, and Darlison says: “The hope is that this treatment may control the disease after patients have had benefit from initial chemotherapy.”
A lot of research is also underway into drugs that target the stem cells of the cancer that are not killed by chemotherapy and allow tumours to regrow. “These drugs may be far less toxic than chemotherapy and may keep the cancer under control for longer — a potential first for mesothelioma,” says Professor Fennell. The drugs seem to be particularly effective where the cancer has been caused by the gene mutation NF2, which means suitable patients can be specifically targeted.
These drugs may be far less toxic than chemotherapy and may keep the cancer under control for longer — a potential first for mesothelioma
Genetic assessments of patients may also identify which are likely to respond better to surgery as well as chemotherapy, and genetic research could also investigate why some patients’ personal biology means the disease progresses very slowly.
Other positive developments include the government’s identification of mesothelioma as a research priority, while healthcare professionals and scientists are increasingly interested in working in this area.
Meanwhile, Professor Fennell, who becomes chair of the International Mesothelioma Interest Group in October says: “I plan a massive effort to lobby for a complete international ban on the mining and use of asbestos.”