Ask the Experts - Investigational Agents for Mesothelioma?
Ask the Experts - Investigational Agents for Mesothelioma?
I would like to know more about targeted antifolate and onconase therapy in mesothelioma of the lung.
Dr. Rajesh
MTA (LY231514) is an investigational multitargeted antifolate that inhibits thymidylate synthetase, dihydrofolate reductase, and glycinamide ribonucleotide formyltransferase. Initial phase II trials focused on cancers of the colon, lung, and breast, and demonstrated some clinical activity. Patients with mesothelioma were not included in these initial trials, but in 2 subsequent phase I trials in refractory patients, MTA was tested in combination with cisplatin or carboplatin. In the MTA/cisplatin trial, 4 of 6 evaluable patients with mesothelioma had partial responses; 4 of 6 mesothelioma patients in the MTA/carboplatin trial also responded. In order to better assess the single-agent activity of MTA, a phase II trial specifically designed for patients with mesothelioma has just been completed. Although some responses have been documented, final results from this trial are not yet available. A second trial in mesothelioma, comparing cisplatin vs cisplatin/MTA, is also ongoing.
Onconase is an investigational ribonuclease protein derived from the eggs and early embryos of the leopard frog. Initial phase I and II testing demonstrated some clinical activity in several cancer types. However, subsequent trials have been less encouraging. In completed trials, onconase showed no activity against renal cell carcinoma and was inferior to gemcitabine in the treatment of pancreatic cancer. In an early phase II trial in malignant mesothelioma, partial responses were seen in 2 of 15 evaluable patients (13%). A multicenter, confirmatory phase II trial is under way, but results are not yet available.
I would like to know more about targeted antifolate and onconase therapy in mesothelioma of the lung.
Dr. Rajesh
MTA (LY231514) is an investigational multitargeted antifolate that inhibits thymidylate synthetase, dihydrofolate reductase, and glycinamide ribonucleotide formyltransferase. Initial phase II trials focused on cancers of the colon, lung, and breast, and demonstrated some clinical activity. Patients with mesothelioma were not included in these initial trials, but in 2 subsequent phase I trials in refractory patients, MTA was tested in combination with cisplatin or carboplatin. In the MTA/cisplatin trial, 4 of 6 evaluable patients with mesothelioma had partial responses; 4 of 6 mesothelioma patients in the MTA/carboplatin trial also responded. In order to better assess the single-agent activity of MTA, a phase II trial specifically designed for patients with mesothelioma has just been completed. Although some responses have been documented, final results from this trial are not yet available. A second trial in mesothelioma, comparing cisplatin vs cisplatin/MTA, is also ongoing.
Onconase is an investigational ribonuclease protein derived from the eggs and early embryos of the leopard frog. Initial phase I and II testing demonstrated some clinical activity in several cancer types. However, subsequent trials have been less encouraging. In completed trials, onconase showed no activity against renal cell carcinoma and was inferior to gemcitabine in the treatment of pancreatic cancer. In an early phase II trial in malignant mesothelioma, partial responses were seen in 2 of 15 evaluable patients (13%). A multicenter, confirmatory phase II trial is under way, but results are not yet available.
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