Late-Stage Mesothelioma Treatment Could Be More Effective with Bevacizumab
Cisplastin and Pemtrexed: The Chemotherapy Gold Standard
Until now, cisplastin and pemetrexed (Almita) have been regarded as the gold standard for first-line chemotherapy treatment.
Chemotherapy works by preventing cell divison, interrupting the cell
cycle to prevent new cancer cells from forming. Chemotherapy drugs
accomplish this by killing off cells that rapidly divide. It is where
the treatment is most effective.
Austliya mobile pemetrexed are
often chosen because they work very well together. Cisplastin is a cell
cycle non-specific alkylating agent – put simply, it keeps cells from
rapidly dividing during the resting phase of cell division. Pemetrexed,
on the other hand, is a cell cycle specific antimetabolite, meaning that
if it is introduced during and active phase of cellular metabolism
during an active phase, the cells will not divide.
The cooperation
of the two drugs is the primary reason they have been used as the gold
standard for treatment. They effectively work together to eliminate
cancer cells during both the active and resting phases of mitosis. Using
both drugs covers both sides of the mitosis equation, which can lead to
remission for many mesothelioma patients.
The Problem with Chemotherapy
However,
as with all chemotherapy treatment, the infusion drugs cannot
differentiate between cells that are cancerous and those that are
normal. It aggressively targets any cell in the body that divides
rapidly.
This is why chemotherapy side effects such as nausea,
diarrhea, hair loss, mouth sores, and low blood counts are common.
Healthy areas of the body such as bone marrow, the lining of the
intestines and mouth, and hair follicles produce cells that divide
quickly too. Once chemotherapy begins, it is indiscriminate, killing
both the cancerous and non-cancerous cells that rapidly divide.
The
side effects mentioned above usually stop once treatment is finished.
With cancerous cells gone, healthy processes can continue unaffected by
chemotherapy – and the body can begin to heal.
Enter Bevacizumab
Research
is constantly underway to improve first line chemotherapy treatment in
regards to patient care. This is where bevacizumab (Avastin) could play a
role.
Classified as an angiogenesis inhibitor, bevacizumab
inhibits the growth of new blood vessels. These are blood vessels that
could be used to feed certain cancerous cell production cycles, or
worse, cancerous tumors.
The promise of bevacizamub lies in its
operation. It is very specific and works similarly to a lock and key.
Your body constantly creates antibodies to respond to germs that enter
the body. These antibodies will attach themselves to the protein found
in a germ (called antigens), and “mark” them for destruction by your
body's immune system. Cancer researchers have identified certain
antigens in cancer cells and developed special antibodies from animal
and human proteins to target them. Since they are specific to particular
types of cancer cells, the toxicity potential for healthy cells is
diminished.
Bevacizamub works by targeting human vascular
endothelial growth factor (HVEG). This is a small protein that is
responsible for new blood vessel formation when it interacts with
certain receptors found in the body. The blood vessels that form could
be used to feed the cancerous cell production cycles and tumors
mentioned previously.
Currently, bevacizumab is most often used to
treat metastatic colon/rectal cancer, certain types of lung cancer,
breast cancer, glioblastoma, and renal cell carcinoma.
How Bevacizumab Can Make a Difference
A recent study
funded by Intergroupe Francophone de Cancerologie Thoracique holds some
findings worth noting. In the study, a Phase 3 trial was conducted
using bevacizumab with patients between the ages of 18 and 75. All
patients were diagnosed with unresectable malignant pleural
mesothelioma, had not received any prior chemotherapy, and had a life
expectancy of less than 12 weeks prior to entering treatment.
The
results of the study are pretty incredible. After the combined treatment
of bevacizumab, cisplatin, and pemetrexed, the average survival rate
was 18.8 months – an increase of more than 15 months over the pretrial
prognosis! The study also noted some potentially negative effects,
including an increase in the chemical creatinine (a byproduct of the
process that supplies muscles with energy), increased proteinuria levels
(high levels of protein in the urine, a potential sign of kidney
problems), and a somewhat higher incidence of hemorrhage. However, the
overall increase in survival rate seems to outweigh any of these other
problems.
So what does this mean for future first-line
chemotherapy treatment for mesothelioma? The horizon appears bright. If
survival rates were increased from less than 12 weeks to almost 19
months with individuals in advanced stages of malignant mesothelioma, it is possible that introducing bevacizumab earlier during the treatment process could yield even better results.
The
investigators of the study concluded the following: "addition of
Bevacizumab to Pemetrexed plus Cisplatin significantly improved [overall
survival] in malignant pleural mesothelioma at the cost of expected
manageable toxic effects; therefore it should be considered as a
suitable treatment for the disease."
Only time will bear the
findings out in full, but the study seems to suggest that adding
bevacizumab to an existing first-line chemotherapy treatment regimen
helps. It is one addition that could revolutionize chemotherapy
treatment for mesothelioma by both extending life and providing a better
quality of life for those who survive.

