New Groundbreaking Treatment for Mesothelioma

In a remarkable advancement in the fight against mesothelioma, a form of cancer notoriously difficult to treat caused by asbestos exposure, a new drug has emerged, marking the most significant progress in the last two decades. Mesothelioma, which typically manifests in the lining surrounding the lungs, is an aggressive and lethal disease with one of the lowest survival rates among cancers. This new treatment offers a glimmer of hope for thousands diagnosed with the disease worldwide each year.

The innovative therapy, celebrated for its "truly wonderful" potential, promises to bring solace to patients and their loved ones. The drug's effectiveness was demonstrated in an international trial led by Queen Mary University of London, which spanned across five countries. This groundbreaking study revealed that the new drug, which disrupts the tumor's nutrient supply, significantly improved three-year survival rates by quadrupling them. The results of this trial were published in the prestigious JAMA Oncology journal on February 15, 2025 entitled Pegargiminase Plus First-Line Chemotherapy in Patients With Nonepithelioid Pleural Mesothelioma.

A testament to the drug's impact comes from a patient who, after being exposed to asbestos in the 1970s, was diagnosed with mesothelioma and given a mere four months to live. Now, five years post-trial, he celebrates life alongside his five grandchildren and two great-grandchildren, attributing his extended time to this medical breakthrough.

The significance of this development cannot be overstated, given mesothelioma's notorious resistance to treatment. The drug in question, ADI-PEG20 (pegargiminase), stands out as the first in two decades to be effectively combined with chemotherapy, offering a new beacon of hope. The trial involved patients from the UK, USA, Australia, Italy, and Taiwan, all undergoing chemotherapy and either receiving the new drug or a placebo over two years.

The study focused on 249 individuals with pleural mesothelioma, with an average age of 70, across 43 centers in the participating countries from 2017 to 2021. Those treated with pegargiminase and chemotherapy showed a median survival of 9.3 months, an improvement over the 7.7 months for those on placebo and chemotherapy. Furthermore, the "progression-free survival" rate was also higher for the pegargiminase group.

This pivotal trial not only extended the median overall survival by 1.6 months but also dramatically increased the three-year survival rate, showcasing the drug's tolerability and safety.

The journey to this discovery began two decades ago with Professor Peter Szlosarek's identification of a unique vulnerability in mesothelioma cells - a deficiency in a protein called ASS1, crucial for synthesizing the amino acid arginine. ADI-PEG20 exploits this vulnerability by depleting arginine levels in the blood, effectively starving the cancer cells and inhibiting their growth.

This breakthrough is a culmination of years of dedicated research, transforming our understanding of cancer cell biology and offering new hope to those afflicted with mesothelioma. Funded by Cancer Research UK and the biotechnology firm Polaris Group, this study underscores the importance of discovery research in unveiling new therapeutic targets.

As we celebrate this significant achievement, it's crucial to acknowledge the collective effort of the mesothelioma community, including doctors, nurses, patients, and families, in pushing the boundaries of treatment. With this new option on the horizon, there's renewed optimism for those facing mesothelioma, marking a pivotal moment in the ongoing battle against this formidable disease.