Perth Research: new treatment brings hope for rare cancer

A new treatment combining standard chemotherapy with an immunotherapy agent may provide a long overdue improvement in the treatment of mesothelioma.

A new clinical trial is looking to improve the survival outcome of patients with advanced malignant pleural mesothelioma, using a combination of standard chemotherapy and an immunotherapy agent.

The study is led by Dr Alistair Cook, Research Fellow, at UWA’s School of Biomedical Sciences, and provides the first new treatment for mesothelioma in over 30 years.

About this disease
Mesothelioma is a rare and hard to treat cancer, caused by prolonged exposure to asbestos. The cancer can affect the outer lining of the lungs, the chest wall lining, and even the lining of the heart. Despite being a rare cancer worldwide, Western Australia has one of the world’s higher rate of incidence of this cancer, due to our past involvement in asbestos mining.

Every year up to 800 people are diagnosed with mesothelioma and most of them will die from their condition: the survival rate is currently less than 3% in men and 12% in women.

“We have one of the world’s highest rates per head of population in WA since it was mined here and used heavily. Aside from those exposed in industrial settings (mining, ship building, construction workers), a more recent wave of people exposed through DIY and home renovation in older houses is ongoing,” Dr Cook said.

For people exposed to asbestos, there is a large gap from the time of exposure to when initial diagnosis of the cancer is done. But, once it is diagnosed, the prognosis is almost always fatal. “There is a lag time of 20-30 years between asbestos exposure and diagnosis of mesothelioma, but the disease is almost universally fatal within an average of just over a year,” Dr Cook said.

“Even with the best current chemotherapy drugs, average survival is only extended by approximately 3 months – and this treatment has been in place for almost 30 years!” he added.

Hence, there is a dire need to develop effective new treatments for this condition.

About the study
The new clinical trial aims to determine the effectiveness of adding the immunotherapy agent durvalumab to the standard chemotherapy treatment, which involves cisplatin and pemetrexed, in patients with advanced malignant pleural mesothelioma.

Durvalumab has been shown to be an effective anti-cancer agent in a previous phase 2 clinical trial examining the use of chemotherapy and immunotherapy in 54 people with malignant mesothelioma. The results of this trial, published last year, warranted to design of the current phase 3 clinical trial.