Response to the posting “Mesothelioma: Finally, a cure called NGR-hTNF?”

Janet I thought that the best way to address this question would be for all of us to look at the abstract and discover what the results of this Phase II Clinical Trial will mean to mesothelioma patients.

This study is promising, but a cure… not yet… A possible new treatment option… maybe. The drug in question holds promise and is an agent that targets the new blood vessels that supply tumors. This trial enrolled 57 mesothelioma patients who had received prior treatment.  This abstract discussed the results of two cohorts of patients who were given this drug on two different schedules. The trial was a Phase II study which means that they knew the safe dose of the drug but the activity was still to be determined.  This new agent was tested against best supportive care which means that patients were randomized to receive comfort measures (i.e. palliative care) and the other group received this drug. This was not a placebo controlled trial but best supportive care which can vary among providers.  The supportive care needs of patients are diverse so I do not think there will be a standard that can be universally applied to a cancer patient population. This drug was reported to be more efficacious than support care measures in 46% of the patients who participated.  In the overall study population (N = 57), median PFS (progression free survival) was 2.8 months. Median progression-free time (stable disease) was 4.7 months in twenty-six patients (46%) who achieved disease control. Median survival was 12.1 months. 54% of the patients did not benefit from NGR-hTNF.

I do suggest that we monitor this drug during its development phase and I would suggest that patients add this to the list of clinical trials that they might consider participation. This trial was small and had two different schedules so if they decide to proceed in testing in mesothelioma they will need to conduct a trial with a large number of mesothelioma patients and all of the subjects treated using the same dose and schedule.I am eagerly awaiting the results of the Vorinostat (Zolinza) trial for 2^nd line. Other trials results that are expected during the Spring/Summer would be the trial of Pemetrexed (Alimta)/ Cisplatin and MORAb009 vs Pemetrexed and Cisplatin alone and the large French Intergroup Study looking at the combination of Pemetrexed/Cisplatin/Bevacuzimab(Avastin) vs. {Pemetrexed/Cisplatin alone.

View the abstract here.

~Mary Hesdorffer, NP