The Moffitt Cancer Center in Tampa later this month will launch the first pleural mesothelioma clinical trial in the U.S. that will deliver repeated, high-dose chemotherapy directly to the site of tumors.
The trial is designed as a second-line therapy for patients with inoperable or recurrent mesothelioma that no longer responds to standard chemotherapy or radiation. Although the treatment does not aim to cure the cancer, researchers expect it to extend survival and improve quality of life.
During the procedure, doctors will identify the specific blood vessels that feed the tumors, and then they will overload them with chemotherapy to hopefully slow or stop the growth of mesothelioma. Directly targeting the tumors will allow a patient to avoid much of the often debilitating side effects of systemic chemotherapy, in which anti-cancer drugs circulate throughout the entire body.
“This is very exciting, to be the first center to offer something like this,” Dr. Jacques Fontaine, director of the Mesothelioma Research and Treatment Center at Moffitt, told Asbestos.com. “We think this could be an effective option for patients who thought they were out of options.”
Moffitt is calling it the Mesothelioma Selective Chemoperfusion Study.
In the past, a similar chemoperfusion strategy for the treatment of liver cancer has been successful at select cancer centers across the nation.
The Goethe University Medical Center in Frankfurt, Germany, and the Cairo University Hospital in Egypt have used it successfully for mesothelioma treatment since 2013.
“No one is saying this will cure the cancer,” Fontaine said. “But it should help, particularly for quality of life and life extension. It allows you to use higher doses of chemotherapy that go directly to the blood vessels feeding the tumors, and thus minimize exposure to the rest of the body. It maximizes the chemotherapy and minimizes the side effects. It makes sense.”
The results from Germany and Egypt reported that 49 percent of patients whose tumors had failed to respond to systemic chemotherapy achieved stable disease with chemoperfusion and 36 percent showed tumor reduction.
Dr. Bela Kis, noted interventional radiologist, will be directing the trial at Moffitt. The study will follow patients who receive the treatment once a week for four to eight weeks, depending upon how they respond. Kis specializes in image-guided tumor therapy.
Doctors use an X-ray test called an angiogram to identify the blood vessels that supply tumors the oxygen and nutrients they need to grow and spread. Next, they guide the infusion catheter from the femoral artery in the thigh through the aorta to target these feeding vessels. Tumor cells absorb much of the chemotherapy, which remains in the chest area, limiting side effects.
Fontaine believes the chemoperfusion trial at Moffitt combines several approaches that have worked well in the past. The trial takes some of what has worked with liver cancer, and mixes it with the intrathoracic heated chemotherapy technique that renowned surgeon Dr. David Sugarbaker first made popular.
Sugarbaker often uses high doses of chemotherapy to directly bathe the thoracic cavity as part of his aggressive mesothelioma surgery. But it ends when surgery ends.
The Selective Chemoperfusion Study at Moffitt allows weekly, high dose chemotherapy to go directly to the tumors but without major side effects.
Anyone interested in the upcoming mesothelioma trial can contact Moffitt Cancer Center directly or the Patient Advocates at The Mesothelioma Center. Moffitt will begin recruiting patients later this month. More information on Fontaine and his work can be found on his website.
Under Fontaine’s leadership, Moffitt has become one of the leading mesothelioma specialty centers in the country, providing an extensive, multidisciplinary approach to treatment.
Moffitt recently completed four mesothelioma clinical trials, and also is actively recruiting for an immunotherapy trial involving a genetically modified version of Listeria.