Novel platinum agents and mesenchymal stromal cells for thoracic malignancies: state of the art and future perspectives

Our plain-English summary of Novel platinum agents and mesenchymal stromal cells for thoracic malignancies: state of the art and future perspectives, by F. Petrella, I. Rimoldi, G. Facchetti, et al (Expert Opinion on Therapeutic Patents, 2018).

The study

• Authors: F. Petrella, I. Rimoldi, G. Facchetti, L. Spaggiari
• Journal: Expert Opinion on Therapeutic Patents
• Published: 2018;28(11):813-821
• Type of article: Review
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Introduction: Non-small cell lung cancer and malignant pleural mesothelioma represent two of the most intriguing and scrutinized thoracic malignancies, presenting interesting perspectives of experimental development and clinical applications.

Areas Covered: In advanced non-small cell lung cancer, molecular targeted therapy is the standard first-line treatment for patients with identified driver mutations; on the other hand, chemotherapy is the standard treatment for patients without EGFR mutations or ALK rearrangement or those with unknown mutation status. Once considered an ineffective therapy in pulmonary neoplasms, immunotherapy has been now established as one of the most promising therapeutic options. Mesenchymal stromal cells are able to migrate specifically toward solid neoplasms and their metastatic localizations when injected intravenously. This peculiar cancer tropism has opened up an emerging field to use them as vectors to deliver antineoplastic drugs for targeted therapies.

Expert Opinion: Molecular targeted therapy and immunotherapy are the new alternatives to standard chemotherapy. Mesenchymal stromal cells are a new promising tool in oncology and-although not yet utilized in the clinical practice, we think they will represent another main tool for cancer therapy and will probably play a leading role in the field of nanovectors and molecular medicine.

In plain English

This was a review article on medical treatment of two chest cancers: non-small cell lung cancer (NSCLC) and malignant pleural mesothelioma (MPM). The authors describe MPM as a rare, fatal asbestos-related tumor. The review did not study asbestos exposure or new patients. Citing published studies, it reported that the approved first-line treatment for MPM, pemetrexed plus cisplatin, is associated with a median overall survival of about 12 months. It reported that there are no approved second-line treatments, and that median survival with second-line therapy ranges from 5 to 10 months. It described early trials of the immunotherapy drugs pembrolizumab and nivolumab in MPM, and new platinum compounds tested on cancer cells in the laboratory. It also described mesenchymal stromal cells, which can travel toward tumors and might be used to carry drugs. The authors noted their own earlier laboratory work, in which such cells loaded with paclitaxel or with a platinum compound inhibited the growth of human mesothelioma cells in vitro. The authors concluded that this cell-based approach is still preclinical, but they expect it to become a main tool for cancer therapy.

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: narrative review of preclinical and clinical literature on medical therapy
• Who was studied: No study population of its own; the review covered published research on non-small cell lung cancer and malignant pleural mesothelioma, with brief mention of small cell lung cancer and thymic neoplasms
• Exposure: No asbestos exposure was studied. The review concerned treatments (chemotherapy, new platinum compounds, targeted therapy, immunotherapy, mesenchymal stromal cells). Mesothelioma is described as asbestos-related.
• Main results:
  • From cited literature: first-line pemetrexed plus cisplatin for MPM is associated with a median overall survival of approximately 12 months
  • From cited literature: there are no approved second-line treatments for MPM, and median overall survival with second-line therapy ranges from 5 to 10 months
  • From cited literature: PD-L1 is expressed in up to 40% of patients with malignant pleural mesothelioma
  • From cited literature: initial results from a non-randomized, open-label phase 1b trial suggested pembrolizumab might be safe in malignant pleural mesothelioma
  • From a cited single-arm phase II trial: nivolumab showed clinical activity and an acceptable safety profile as second-line treatment in mesothelioma
  • The authors' own earlier laboratory work: mesenchymal stromal cells loaded with paclitaxel, or with a cationic platinum(II) complex, inhibited the proliferation of human mesothelioma cells in vitro
  • From cited literature: platinum-based chemotherapy for metastatic NSCLC gives median survivals of 8-12 months
• The authors' conclusion: The authors concluded that targeted therapy and immunotherapy are already in clinical use, while drug delivery by mesenchymal stromal cells is still preclinical. They wrote that they think these cells will become another main tool for cancer therapy.

Topics

Medical terms in this study, explained in our Lexicon: State-of-the-Art Defense, Non-Small Cell Lung Cancer, Pleural Mesothelioma, Targeted Therapy, Chemotherapy, EGFR, Neoplasm, Immunotherapy.

Related studies

• Antitumor effects of TRAIL-expressing mesenchymal stromal cells in a mouse xenograft model of human mesothelioma — M.J. Lathrop, E.K. Sage, et al. (2015)
• Paclitaxel-releasing mesenchymal stromal cells inhibit in vitro proliferation of human mesothelioma cells — F. Petrella, V. Coccè, et al. (2017)
• Antibody drug conjugates in thoracic malignancies — J.M. Pacheco, D.R. Camidge (2018)
• I-O Optimise: a novel multinational real-world research platform in thoracic malignancies — S. Ekman, F. Griesinger, et al. (2019)
• Retrospective study of hypersensitivity reactions to chemotherapeutic agents in a thoracic oncology service — H. Capelle, C. Tummino, et al. (2018)
• Systemic but not topical TRAIL-expressing mesenchymal stem cells reduce tumour growth in malignant mesothelioma — E.K. Sage, K.K. Kolluri, et al. (2014)

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