A six-year study conducted by French doctors into a new chemotherapy combination for advanced malignant mesothelioma found that bevacizumab added to standard care improved patient survival by inhibiting a vascular endothelial growth factor. The study, “Bevacizumab for newly diagnosed pleural mesothelioma in the Mesothelioma Avastic Cisplatin Pemetrexed Study (MAPS): a randomized controlled, open-label, phase 3 trial,” was published in the journal The Lancet.
The vascular endothelial growth factor promotes the growth of malignant pleural mesothelioma cells, so targeting this factor further help these patients.
Bevacizumab (Avastin, Genentech) is a U.S. Food and Drug Administration (FDA)-approved angiogenesis inhibitor, a drug that slows the growth of new blood vessels. It is approved for a number of cancers, including certain colon, lung, and ovarian cancers. Specifically, bevacizumab is a recombinant humanized monoclonal antibody that blocks angiogenesis by inhibiting the vascular endothelial growth factor A (VEGF-A). VEGF-A is a chemical signal that stimulates angiogenesis in a variety of diseases, especially in cancer.
With the aim of assessing the effect on survival of bevacizumab when combined with the present standard of care, cisplatin plus pemetrexed (Alimta), as a first-line treatment of advanced malignant pleural mesothelioma, the team of researchers randomly assigned 448 French mesothelioma patients into two groups — those receiving standard care and those also receiving Avastin. The trial was part of the Phase 3 Mesothelioma Avastin Cisplatin Pemetrexed Study (MAPS).
Trial results revealed that patients in the Avastin group lived an average of 2.7 months longer than those in the standard chemotherapy group, which researchers said was the longest overall survival ever reported in a major, controlled trial of advanced mesothelioma.
“Addition of bevacizumab to pemetrexed plus cisplatin significantly improved overall survival in malignant pleural mesothelioma at the cost of expected manageable toxic effects,” wrote the study’s lead author, Dr. Gérard Zalcman, an oncologist and researcher with the University of Caen, according to a press release.
The survival findings are noteworthy, given the marginal effectiveness of the standard chemotherapy regimen in advanced malignant pleural mesothelioma patients.
Malignant pleural mesothelioma is an aggressive cancer with a poor prognosis that is linked to asbestos exposure. The disease is the most common of the four types of mesothelioma, accounting for about 75 percent of the 2,000 cases diagnosed annually in the U.S.