Anti-Cancer Treatment May Bring Mesothelioma Closer to Becoming a Manageable Chronic Condition

• Nancy Meredith
• Mesothelioma

Although mesothelioma is an incurable cancer, more and more patients are living long, productive lives after diagnosis. For them, the disease has become a chronic condition they can manage rather than a cancer that consumes them. Now, one anti-cancer drug is keeping some cancer patients alive and well for many years beyond their initial prognosis.

According to a March 9 NBC News story, Gleevec (imatinib), a daily drug for chronic myelogenous leukemia (CML), has been successful in keeping patients with the cancer alive for more than 10 years.

http://www.nbcnews.com/health/cancer/cancer-pill-gleevec-keeps-patients-alive-well-decade-n730951

In a study funded by Novartis, the maker of the drug, researchers found that 83 percent of patients lived 10 years or longer, with minimal side-effects from the drug.

Before Gleevec, CML patients had to endure highly toxic chemotherapy treatments or submit to a bone marrow transplant. Without either of those options, the patient’s prognosis was grim, said Dr. Richard Silver, a hematologist and oncologist at New York Presbyterian-Weill Cornell Medical Center who helped first test the drug in patients.

The Gleevec study results were so good that the trial was halted and all patients were given the drug, the U.S. FDA approved the drug, and, according to the Leukemia & Lymphoma Society, somewhere from 36,000 to 100,000 Americans are now CML survivors. Ultimately, some patients are able to stop taking the drug, however, they are monitored closely and can go back on the drug if needed.

“To have lived through the opportunity where we can go to a patient and say, ‘We have got this new drug and it looks great’ and it is great,” Silver said. “You can imagine what a thrill it is to see these people and see them live their lives productively, with their jobs and their families and children and grandchildren.”

A chronic disease is one lasting three months or more, by the definition of the U.S. National Center for Health Statistics. About one- fourth of people with chronic conditions have one or more daily activity limitations. Chronic diseases generally cannot be prevented by vaccines or cured by medication, and they also do not disappear. However, the disease is often considered manageable and patients can live their lives.

In separate studies, research points to the possible use of imatinib in the support of lung cancer and mesothelioma patients. In a 2016 study, researchers from the Cancer Research UK, Manchester Institute found the Abelson (ABL) family of nonreceptor tyrosine kinases, ABL1 and ABL2, are “mutated or amplified” in nearly 10% of lung cancer cases and are key to tumor growth. The researchers turned to imatinib, an ABL inhibitor, and found in the lab that it effectively blocked tumor growth. A 2008 study by researchers in Italy found that imatinib “enhances the therapeutic response to gemcitabine” in combination treatment for malignant mesothelioma.

Pleural mesothelioma, an asbestos-caused cancer of the lining of the lungs, is often treated with similar protocols as lung cancer. Both cancers have shown to be aggressive and often reject and defeat many of the common treatments. However, care that has been shown to be successful in helping patients with other challenging cancers continue living a productive life brings hope to the mesothelioma community. The community will be keeping an eye on further Gleevec studies in the hopes the research could translate to mesothelioma care.

“It [CML] was really a death warrant. This has been the thrill of my life,” Dr. Silver told NBC News.

Read the full study on Gleevac in the March 9 issue of the New England Journal of Medicine.

http://www.nejm.org/doi/10.1056/NEJMoa1515725

Photo Credit: NBC News