Targeting the tumour vasculature in mesothelioma

Our plain-English summary of Targeting the tumour vasculature in mesothelioma, by D.A. Fennell (The Lancet. Oncology, 2018).

The study

• Author: D.A. Fennell
• Journal: The Lancet. Oncology
• Published: 2018;19(6):723-724
• Type of article: Comment
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This article is a short commentary, not an original study. The author discussed the NGR015 phase 3 trial by Gregorc and colleagues. That trial tested NGR-hTNF, a drug meant to disrupt tumour blood vessels, in an unselected group of patients with mesothelioma. Patients received the investigator's choice of chemotherapy or best supportive care, plus either NGR-hTNF or placebo. As the commentary describes it, the trial found no significant difference in overall survival, its main endpoint. However, the trial's authors reported a significant interaction between a short treatment-free interval after first-line treatment and better overall and progression-free survival. The author suggested that the mixed control group might have undermined the drug's activity. A future study could pair NGR-hTNF with a single active chemotherapy, possibly a spindle poison such as vinorelbine. The author noted that it is not known whether tumours with short treatment-free intervals show markers such as high CD13 expression. The commentary does not address asbestos exposure. The author concluded that one size does not fit all in mesothelioma drug development.

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: Commentary (journal 'Comment') on a phase 3 trial published by other authors; no new data
• Who was studied: No study population of its own. The commentary discusses the NGR015 trial, which tested NGR-hTNF in an unselected population of patients with mesothelioma.
• Exposure: Asbestos exposure is not discussed. The treatment discussed is NGR-hTNF (a vascular disrupting agent) or placebo, each added to the investigator's choice of chemotherapy or best supportive care.
• Main results:
  • As reported in the commentary, the NGR015 trial (Gregorc and colleagues) found no significant difference in overall survival between groups, which was its primary endpoint. Those authors reported a significant interaction between a short treatment-free interval and more favourable overall and progression-free survival.
  • The commentary's author suggested that the heterogeneous control group in NGR015 might have undermined the activity of NGR-hTNF.
  • The commentary's author suggested that a spindle poison such as vinorelbine might be an appropriate chemotherapy partner for NGR-hTNF in a future study.
  • The commentary's author stated that it is not known whether mesotheliomas with short treatment-free intervals show biological markers of greater NGR-hTNF sensitivity, such as high CD13 expression.
• The authors' conclusion: The author concluded that NGR015 is another cautionary lesson in mesothelioma drug development: one size does not fit all.

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

• Targeting the vasculature: anti-angiogenic agents for malignant mesothelioma — P.L. Chia, P.A. Russell, et al. (2016)
• NGR-hTNF in combination with best investigator choice in previously treated malignant pleural mesothelioma (NGR015): a randomised, double-blind, placebo-controlled phase 3 trial — V. Gregorc, R.M. Gaafar, et al. (2018)
• Tumour suppressor microRNAs contribute to drug resistance in malignant pleural mesothelioma by targeting anti-apoptotic pathways — M. Williams, Y.Y. Cheng, et al. (2019)
• Targeted drug delivery and penetration into solid tumors — A. Corti, F. Pastorino, et al. (2012)
• Mitochondrial biogenesis in the pulmonary vasculature during inhalational lung injury and fibrosis — M.S. Carraway, H.B. Suliman, et al. (2008)
• Effect of syndecan-1 overexpression on mesenchymal tumour cell proliferation with focus on different functional domains — F. Zong, E. Fthenou, et al. (2010)

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