The results of a 2016 Phase III trial of the monoclonal antibody bevacizumab (Avastin) have established another option for treatment for those suffering from malignant pleural mesothelioma.
Angiogenesis, which is the formation of new blood vessels, plays a key role in mesothelioma because it allows the tumors and cancer to spread. However, scientists and researchers have learned that the vascular endothelial growth factor (VEGF) and its receptor (VEGFR) assist in new blood vessel formation, and if that protein can be controlled or halted, it could stop the tumors from multiplying.
The Phase III trial, which took place in France, studied 448 patients suffering from pleural mesothelioma. Chosen at random, patients either received a more standard combination chemotherapy treatment of pemetrexed and cisplatin (PC), or the new three drug treatment that included bevacizumab (PCB).
After six rounds of treatment, those in the PCB group continued with bevacizumab every three weeks until PB or limiting toxicity. The tumors were evaluated after every three cycles of treatment. Median overall survival improved from 13 months for those in the PC group, to 17.3 months in the PCB group. Bevacizumab is not necessarily a new drug; its discovery dates back to 1997. That past 20 years has been spent on trying to improve out VEGF binding by replacing several amino acids.
Researchers and scientists have found this news promising, as mesothelioma is one of the more difficult cancers to treat. Surgery is a limited option for most who are suffering because the cancer is typically in the advanced stages once it is found. Chemotherapy and radiation have found some success, but in many cases it is ineffective. Combination treatments, such as combining surgery techniques and chemotherapy, or combining types of chemotherapy, have shown promise. It has prompted scientists and researchers to try different combinations in hopes of finding the ultimate solution.
Those at risk of serious side-effects from bevacizumab did not participate in this study so it is important to remember that this type of three-drug regimen will not be appropriate for all those who are suffering from mesothelioma. However, the latest research, as it was a Phase III trial, has established that a combination of pemetrexed, cisplatin, and bevacizumab is now a treatment option for those with pleural mesothelioma.
Levin, PA, and Dowell, JE, “Spotlight On Bevacizumab And Its Potential In The Treatment Of Malignant Pleural Mesothelioma: The Evidence To Date,” OncoTargets and Therapy ( April 7, 2017). [Link]