Wednesday 22 August 2012

Trials and tribulations

Shortly after Steve was diagnosed with mesothelioma in June 2009, he was offered and accepted the opportunity to take part in a drug trial using a combination of cisplatin and bortezomib (Velcade) a biological therapy.  He completed the full six cycles of treatment.  Although the tumour did not shrink, his condition has remained stable in the three years since treatment.  

From time to time, we wonder whether the trial has been successful, so I scan the daily google alerts on mesothelioma to look out for results.  Today's alert included reports from the August edition of the Journal of Thoracic Oncology, in an article entitled New Chemo Research:  Good and Bad News for Mesothelioma.  

The good news concerned a study to predict patients responsiveness to Pemetrexed (aka Alimta) which is the current gold standard for treating the disease, and a promising outcome of a trial of "Sunitinib" as second line chemotherapy treatment for mesothelioma.  The bad news concerned Bortezomib - the trial drug which Steve took back in 2009.  Given Steve's sustained period free of disease progression, that news came as a bit of a shock.

Curious, I decided to investigate further.  The report is from a drug trial in Ireland, which only used Bortezomib in isolation, rather than in combination with a platinum-based drug as in Steve's trial.  Only ten patients took part in the drug trial as a "first line" treatment (like Steve) and none showed evidence of a positive response.  There is no mention of progression-free or overall survival rates in this small group of patients.  Nevertheless, based on these findings, the article concludes that Bortezomib monotherapy doesn't warrant further investigation, which is disappointing to say the least.

However, further research has revealed that trials involving Bortezomib are currently still recruiting in England, at St Barts and the Royal Marsden, as well as in Ireland, Scotland, Belgium and the Netherlands, which suggests that perhaps the outcome of the Irish research is not as clear cut as might appear at first.  

Other research in the States is showing promise, in particular treatment based on immunotherapy (SS1P), and the ADAMS trial using ADI-PEG 20 is going strong in the UK (details top right). It's reassuring to know that there are options out there, when the time comes.....You can tell we are now in the run up to Steve's scan on 28 August and the assessment on 13 September, when we hear the results.....The mind-set process of hoping for the best whilst preparing for the news we don't want to hear is now in gear. Must stay positive!


  1. Thanks Linda for the post, hope you don't mind but have also put on my blog page too.

  2. Not a problem at all Jan - if you think it might help someone :-)