Expert Opin Investig Drugs. 2019 Jul 1:1-14. doi: 10.1080/13543784.2019.1638363. [Epub ahead of print]

What can independent research for mesothelioma achieve to treat this orphan disease?

Guazzelli A1, Meysami P1, Bakker E2, Bonanni E3, Demonacos C4, Krstic-Demonacos M1, Mutti L5.

Author information

1

a School of Environment and Life Sciences , University of Salford , Salford , UK.

2

b School of Medicine , University of Central Lancashire , Preston , UK.

3

c National Asbestos Observatory , Rome , Italy.

4

d Faculty of Biology, Medicine and Health, School of Health Sciences , University of Manchester , Manchester , UK.

5

e Sbarro Institute for Cancer Research and Molecular Medicine, Center for Biotechnology, College of Science and Technology , Temple University , Philadelphia , PA , USA.

Abstract

Introduction: Malignant pleural mesothelioma (MPM) is a rare neoplasm with a poor prognosis, as current therapies are ineffective. Despite the increased understanding of the molecular biology of mesothelioma, there is still a lack of drugs that dramatically enhance patient survival. 

Area Covered: This review discusses recent and complete clinical trials supported by the NIH, other U.S. Federal agencies, universities and organizations found on clinicaltrials.gov. Firstly, chemotherapy-based trials are described, followed by immunotherapy and multitargeted therapy. Then we introduce drug repositioning and the use of drug docking as tools to find new interesting molecules. Finally, we highlight potential molecular pathways that may play a role in mesothelioma biology and therapy. 

Expert Opinion: Numerous biases are present in the clinical trials due to a restricted number of cases, inappropriate endpoints and inaccurate stratification of patients which delay the finding of a treatment for MPM. The most crucial issue of independent research for MPM is the lack of more substantive funding to translate these findings to the clinical setting. However, this approach is not necessarily scientific given the low mutational load of mesothelioma relative to other cancers, and therefore patients need a more solid rationale to have a good chance of successful treatment.