Clinical trials of a new anticancer drug combination carried out by Cancer Research UK scientists at Newcastle University show that it has the potential to almost double the life expectancy of sufferers of mesothelioma – a form of lung cancer which affects around 1,700 people in the UK every year – according to a report published in the Journal of Clinical Oncology1.
Mesothelioma is a cancer of the pleura – the membranes that line the inside of the chest and the outside of the lungs. It differs from other types of lung cancer in that it is caused by exposure to asbestos, rather than by smoking. The condition affects five times more men than women, and most commonly develops in men between 50 and 70 years of age.
Mesothelioma is very hard to treat. It is usually inoperable and not very responsive to radiotherapy. With the anticancer drugs previously available, people diagnosed with the disease could expect to survive for only six to eight months.
Now, results of a study by Professor Hilary Calvert, Dr Andrew Hughes and colleagues at the Cancer Research UK Unit at Newcastle University in collaboration with Eli Lilley, have shown that, on average, patients who were given the drug combination, pemetrexed and carboplatin, survived for up to 13 – 14 months. In a handful of cases, patients have survived for three years or more.
Professor Calvert said: “The drug combination showed remarkable activity in mesothelioma. Our study provided the first convincing evidence that adding the new drug pemetrexed to carboplatin could be useful in the treatment of the disease”.
Pemetrexed is manufactured by pharmaceutical company Eli Lilley under the trade name Alimta. It is an anticancer drug based on being an analogue of the B-vitamin, folic acid. Drugs of this class were first developed by Professor Calvert and colleagues at The Institute of Cancer Research in London in the early 1980s with funding from Cancer Research UK, leading to the licensing of a drug called raltitrexed (Tomudex).
Because the interval between exposure to asbestos and developing mesothelioma can be 30 – 40 years, the incidence of the disease is still on the rise, as a result of industrial exposure to asbestos in the 70s and 80s. Currently there are about 1,700 cases per year in the UK, with that figure expected to more or less double by 2020.
The results of the Newcastle trial led Eli Lilley to sponsor a multinational randomised trial in mesothelioma, which was reported at this year’s American Society for Clinical Oncology meeting. The trial showed an improvement of survival and symptoms for the first time in mesothelioma.
Dr Lesley Walker, Director of Cancer Information at Cancer Research UK says: “Mesothelioma is a serious condition that is difficult to treat so this is an important development. We now need to look closely at the drugs performance in the next stages of clinical trials to see how it compares to other anti-cancer drugs.”
- The report of the Newcastle research team ‘Phase I Clinical and Pharmacokinetic Study of Pemetrexed and Carboplatin in Patients With Malignant Pleural Mesothelioma’ is published in the Journal of Clinical Oncology20 (16), 2002. The researchers involved are Andy Hughes, Paula Calvert, Ashraf Azzabi, Ruth Plummer, Rob Johnson, Jim Rusthoven, Melanie Griffin, Kevin Fishwick, Alan V. Boddy, Mark Verrill, and Hilary Calvert.