Hope persists for mesothelioma advances despite setbacks

Our plain-English summary of Hope persists for mesothelioma advances despite setbacks, by B. Furlow (The Lancet. Respiratory Medicine, 2016).

The study

• Author: B. Furlow
• Journal: The Lancet. Respiratory Medicine
• Published: 2016;4(7):545-546
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This is a news feature, not a research study. It presented no original research data and did not discuss asbestos exposure. The author gathered comments from three mesothelioma specialists after AstraZeneca announced in February 2016 that second-line tremelimumab given alone failed to improve overall survival in patients with mesothelioma. Anna Nowak was quoted as saying the trial showed no unexpected safety signals but no evidence of a subgroup who might be benefitting, and that randomised immunotherapy studies in mesothelioma are necessary. Hossein Borghaei called early pembrolizumab response rates from the KEYNOTE-028 trial "very interesting". He said oral tyrosine kinase inhibitors had failed to show activity in an unselected population, and that adding bevacizumab to standard chemotherapy seems to be associated with better survival. Prasad Adusumilli described a phase 1 trial testing the safety of mesothelin-targeted CAR T cells delivered through a catheter into the pleural space. A phase 2 trial at Baylor College of Medicine combining surgery with durvalumab, alone or with tremelimumab, was also mentioned.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: News feature (Spotlight section) reporting interviews with experts about mesothelioma treatment trials. It is not an original research study and not a systematic review.
• Who was studied: No study population. The article quotes three specialists: Hossein Borghaei (Fox Chase Cancer Center, Philadelphia), Prasad S Adusumilli (Memorial Sloan-Kettering Cancer Center, New York) and Anna Nowak (University of Western Australia).
• Exposure: Not applicable. No asbestos or other exposure is discussed. The article concerns mesothelioma treatments (tremelimumab, durvalumab, pembrolizumab, bevacizumab, vaccines, tyrosine kinase inhibitors, CAR T-cell therapy).
• Main results:
  • AstraZeneca announced in February 2016 that second-line tremelimumab monotherapy failed to improve overall survival in patients with mesothelioma. This trial was reported elsewhere, not by this article.
  • Nowak was quoted as saying the tremelimumab trial showed no evidence of a subgroup of patients who may be benefitting.
  • Nowak said the tremelimumab failure, despite encouraging single-arm phase 2 studies, is a reminder that randomised studies of immunotherapy in mesothelioma are necessary.
  • Borghaei described preliminary phase 1b data on second-line pembrolizumab monotherapy from the KEYNOTE-028 trial, reported in 2015, as including "very interesting" response rates. No numbers are given.
  • Nowak noted that mesothelioma has a lower mutation burden than melanoma and non-small cell lung cancer, cancers in which anti-CTLA-4 therapy is effective.
  • Borghaei said trials with oral tyrosine kinase inhibitors have failed to show activity in an unselected patient population, and that vaccine trials have not yet shown success.
  • Borghaei said adding bevacizumab to standard chemotherapy seems to be associated with better survival in mesothelioma.
  • Adusumilli described a phase 1 trial evaluating the safety of mesothelin-targeted CAR T cells given through an indwelling intrapleural catheter. Patients in the trial have mesothelioma or lung or breast cancers. Adusumilli said this approach had shown promise in preclinical animal models.
  • A single-centre phase 2 trial at Baylor College of Medicine will combine surgery (extrapleural pneumonectomy or pleurectomy and decortication) with durvalumab alone or with tremelimumab.
• The authors' conclusion: The article gives no formal conclusion. Its headline frames the experts' views as hope persisting for mesothelioma advances despite the tremelimumab setback.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Mesothelioma.

Related studies

• Tremelimumab combined with durvalumab in patients with mesothelioma (NIBIT-MESO-1): an open-label, non-randomised, phase 2 study — L. Calabrò, A. Morra, et al. (2018)
• Tremelimumab as second-line or third-line treatment in relapsed malignant mesothelioma (DETERMINE): a multicentre, international, randomised, double-blind, placebo-controlled phase 2b trial — M. Maio, A. Scherpereel, et al. (2017)
• Efficacy and safety of an intensified schedule of tremelimumab for chemotherapy-resistant malignant mesothelioma: an open-label, single-arm, phase 2 study — L. Calabrò, A. Morra, et al. (2015)
• Tremelimumab for the treatment of malignant mesothelioma — A. Guazzelli, M. Hussain, et al. (2015)
• Anti-CTLA-4 therapy for malignant mesothelioma — A. Guazzelli, E. Bakker, et al. (2017)
• Tremelimumab for patients with chemotherapy-resistant advanced malignant mesothelioma: an open-label, single-arm, phase 2 trial — L. Calabrò, A. Morra, et al. (2013)

Browse more research in The Lancet. Respiratory Medicine, or return to medical research.