Monday, 10 July 2017

Active agent from the Caribbean sea cucumber could improve treatment for malignant pleural mesothelioma

Researchers at the Comprehensive Cancer Center of MedUni Vienna and Vienna General Hospital have discovered a new option for treating malignant pleural mesothelioma. For the first time in the world, they were able to show in a preclinical study, both in the cell culture and in the animal model, that trabectedin, a chemotherapy drug that is already successfully used for other types of cancer, is also effective against malignant pleural mesothelioma. The active agent originally occurs in the Caribbean sea cucumber, a marine-dwelling tunicate. The study results were recently published in "Molecular Cancer Therapeutics," the therapy-oriented journal of the American Association for Cancer Research (AACR). The initial interim results of a clinical study from Italy confirm these results and show that they are transferable to clinical practice.

With around 90 new cases per year in Austria, malignant pleural mesothelioma is one of the rarer forms of cancer. However, it is on the increase. Malignant pleural mesothelioma is a very aggressive form of cancer that is associated with asbestos and is routinely treated with a combination of chemotherapy, surgery and radiotherapy. Since this particular type of tumour often develops resistance to chemotherapy and radiotherapy, the prognosis is very poor.

In order to improve the treatment options for pleural mesothelioma, an interdisciplinary research cooperative was set up at the CCC in 2008 and this has been very successful in the preclinical discovery and development of therapeutics to treat malignant pleural mesothelioma. In its latest preclinical study, the platform scientists investigated the action of trabectedin in malignant pleural mesothelioma. Trabectedin is an active substance that occurs in the Caribbean sea cucumber, can be synthetically manufactured for therapeutic purposes and has already been successfully used clinically for malignant soft tissue tumours and ovarian cancer.

Combination enhances effectiveness
The researchers led by Walter Berger, Deputy Head of MedUni Vienna's Institute for Cancer Research, and Alireza Hoda, Division of Thoracic Surgery at the Department of Surgery of MedUni Vienna/Vienna General Hospital, had already shown in previous works that trabectedin is very effective against cancer cells, while having minimal impact on healthy pleural cells. Furthermore, the researchers were able to demonstrate clear synergies with cisplatin, a standard therapeutic drug. In order to develop further potential combination therapies with trabectedin, the genome signatures of cells that were sensitive to the administration of trabectedin were compared with those of cell lines that were less sensitive. Berger: "Using bioinformatics, we were able to show that the increased formation of the protein bcl-2, which prevents cell death, reduces the effectiveness of trabectedin." Consequently, the scientists treated the malignant cells with a combination of trabectedin and the bcl-2 inhibitors obatoclax and venetoclax. Hoda: "When trabectedin is combined with these bcl-2 inhibitors, there is a significant improvement in destruction of malignant pleural mesothelioma cells. Trabectedin therefore seems to be a new, effective and safe treatment option for this disease." These preclinical results have just been confirmed by initial positive interim results from a clinical study conducted in Italy.

Berger: "The study has even been met with great interest from people affected. This is evidenced by the fact that the Comprehensive Cancer Centre publication has already been posted online and discussed in several international fora for asbestos and mesothelioma.


News Source:
Medical University of Vienna.

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Mesothelioma

Mesothelioma is a form of cancer that is almost always caused by previous exposure to asbestos. In this disease, malignant cells develop in the mesothelium, a protective lining that covers most of the body's internal organs. Its most common site is the pleura (outer lining of the lungs and internal chest wall), but it may also occur in the peritoneum (the lining of the abdominal cavity), the heart, the pericardium (a sac that surrounds the heart) or tunica vaginalis.

Most people who develop mesothelioma have worked on jobs where they inhaled asbestos particles, or they have been exposed to the dust and fiber in other ways. Washing the clothes of a family member who worked with asbestos can also put a person at risk for developing mesothelioma. Unlike lung cancer, there is no association between mesothelioma and smoking. Compensation via asbestos funds or lawsuits is an important issue in mesothelioma.

The symptoms of mesothelioma include shortness of breath due to pleural effusion (fluid between the lung and the chest wall) or chest wall pain, and general symptoms such as weight loss. The diagnosis may be suspected with chest X-ray and CT scan, and is confirmed with a biopsy (tissue sample) and microscopic examination. A thoracoscopy (inserting a tube with a camera into the chest) can be used to take biopsies. It allows the introduction of substances such as talc to obliterate the pleural space (called pleurodesis), which prevents more fluid from accumulating and pressing on the lung. Despite treatment with chemotherapy, radiation therapy or sometimes surgery, the disease carries a poor prognosis. Research about screening tests for the early detection of mesothelioma is ongoing.

Wikipedia