Mesothelioma patients with a gene mutation could benefit greatly from using an anti-malaria drug called quinacrine. Quinacrine is known by the brand name Atabrine. For a long time, it was the primary anti-malaria drug, but it has been replaced by the preferred chloroquine. Researchers at Penn State found that quinacrine shows great cytotoxicity when used alone for mesothelioma. The most current study has been looking at the synergistic relationship between quinacrine and chemotherapy. Researchers found that quinacrine can make cisplatin deadlier to mesothelioma cells. It was also found that mesothelioma patients with the inactivated NF2 mutation had mesothelioma cells that are more sensitive to quinacrine, and around 60 percent of mesothelioma patients have this mutation.
Quinacrine is very useful and can have many applications outside of malaria. It is useful for treating giardiasis, a parasite caused diarrheal disease. It can also be useful for treating rheumatoid arthritis and lupus. It is not typically thought of as a mesothelioma treatment, but research proves it is a viable option for mesothelioma because it kills patient derived and lab grown mesothelioma cells even at low doses. When the drug was applied to mesothelioma cells, it prevented colonies from forming. It also stops autophagy, which allows cancer cells to reuse old parts of cells and triggers apoptosis, which is the process of cells dying naturally.
The new study was done by the Mayo Clinic and the University of California. The chemotherapy drugs typically used for mesothelioma are pemetrexed and cisplatin, so the researchers combined quinacrine with each drug. The researchers found that there was synergistic cell death with cisplatin but there was no synergistic cell death with pemetrexed.
When testing the combination of quinacrine with the chemotherapy drugs, the researchers found that mesothelioma cells that had a mutation on the NF2 gene were especially reactive to quinacrine. There are not many common mutations of mesothelioma cells, but the NF2 mutation is common enough (60 percent) that many patients with mesothelioma could benefit from the quinacrine and cisplatin combination. Researchers still need to test the combination in more patients, but if it is found to be effective, it will not take much time for doctors to start using it because it is an FDA-approved drug. If researchers want doctors to adopt the treatment quickly, more studies showing that it can be effective need to be performed.