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New Drug ADI-PEG20 ‘Starves’ Mesothelioma Cells, Says BCI

Could a new drug actually starve mesothelioma cells, causing them to die? Researchers at Barts Cancer Institute (BCI) say it can. The drug, known as ADI-PEG20 “deprives tumors of their external source of arginine in the blood (from digested food) by breaking it down.” The tumor cells “then die because they don't have this essential building block to make proteins needed for survival.” This deprivation “changes the way the tumor cells make and distribute their DNA building blocks, and because some chemotherapy drugs target DNA construction, a combination of ADI-PEG20 with chemotherapy could show an even better effect than arginine deprivation alone.”

The initial ADI-PEG20 trial included 68 patients. The results showed that treatment with the arginine-lowering drug significantly slowed disease progression in 44 patients receiving the drug and best supportive care, nearly doubling the progression-free survival, compared with the 24 patients receiving best supportive care alone. “This the first time a targeted drug treatment has been designed for this type of cancer with a positive effect in a randomized study of patients with mesothelioma,” said the team.

ADI-PEG20 is “particularly promising” because “a key issue with chemotherapeutic drugs is their tendency to be quite toxic, due to the fact they affect healthy cells as well as tumor cells. The new drug used in this trial only affects the tumor cells and seems to lack serious side effects.”

A number of clinical trials for ADI-PEG20 on treating pleural mesothelioma are underway, with possible regulatory approval for one of the indications coming in 2018. One current trial—TRAP (Tumors Requiring Arginine to Assess ADI-PEG20 with Pemetrexed and Platinum)—has already revealed “unprecedented responses” from a small group of patients with cancers no longer responding to current treatments. The results showed a “100% disease control rate, including a 78% partial response rate, or tumors actually shrinking.” This is a “significant doubling over the usual 30-40% partial response rate found in similar cancers using current treatments. Importantly, the side effects were no worse than the pem/cis combination alone.”

The TRAP Trial was including patients who had a diagnoses of aggressive mesothelioma, including the sarcomatoid type, which has been untreatable—until now.

Larger Phase II and III trials are currently recruiting in the US, UK, Australia, South Africa, Taiwan, and a number of European countries.

If you have been diagnosed with mesothelioma, talk to your doctor about participating in a clinical trial for potentially life-saving drugs such as ADI-PEG20. Drugs such as these could be effective at treating your specific type of mesothelioma.



Leech, Zoe. "Encouraging Results for a New Mesothelioma Chemotherapy." Barts Cancer Institute. Barts Cancer Institute (BCI), 27 Apr. 2017. Web. 23 Oct. 2017.