A Need for Second-Line Mesothelioma TreatmentsAll patients involved in the study were diagnosed with unresectable mesothelioma and experienced disease progression after standard chemotherapy. There are currently no FDA-approved second-line treatments for mesothelioma available to this patient group, although several are in the developmental stage. Avelumab is one of them. Avelumab works by attacking PD-L1, a protein found on the surface of most cancer cells that prevents a person’s immune system from rejecting the cancer. Avelumab essentially unmasks the cancer cells and allows the immune system to kill them.
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“This database is the largest study to date of patients with mesothelioma treated with an anti-PD-L1 antibody,” Hassan said during the presentation. “Ongoing follow up will further characterize durability of the clinical benefit.”
PD-L1 has become a popular target for several immunotherapy drugs tested on various cancers. Many in the medical community believe immunotherapy is the key to future advancements in treatment.
Avelumab is expected to move to phase II testing for mesothelioma by 2017, which will further explore the safety and effectiveness of the drug on a larger patient group. The drug showed considerable effectiveness for non-small cell lung cancer in a phase Ib trial. Researchers are now testing the drug with other diseases, including cancers of the head and neck, kidneys, ovaries, stomach and bladder.
Other Mesothelioma Trials at NCI
Although the avelumab study for mesothelioma is currently closed, Hassan is lead investigator for several other mesothelioma clinical trials at the National Cancer Institute that are currently recruiting patients.
Anetumab ravtansine, also known as BAY 94-9343, is another immunotherapy drug being explored in a phase II trial for mesothelioma. This drug targets mesothelin, a protein that researchers have connected to tumor progression and resistance to chemotherapy.
Several types of cancer cells produce too much mesothelin, including mesothelioma, pancreatic cancer and ovarian cancer. The protein is a common target for immunotherapy drugs used to treat these cancers.
As part of a randomized trial, researchers will measure anetumab ravtansine against the chemotherapy drug vinorelbine.
Hassan presented trial data for BAY 94-9343 at the ASCO annual meeting earlier this month. In an earlier phase I study of mesothelioma patients who received the drug as a second-line therapy, BAY 94-9343 shrank tumors in 50 percent of patients and had tolerable side effects.
The search for a reliable second-line treatment is critical for patients because the benefits of standard chemotherapy often do not last long in the fight against mesothelioma.