US News and World Report rank MD Anderson as America’s number one cancer hospital, with the facility holding the top spot for the past seven years. 

Now, the Houston-based MD Anderson Cancer Center is launching a phase II clinical trial that will focus on rare, advanced cancers, such as mesotelioma, in conjunction with a promising new immunotherapy drug, vudalimab.

Establecimiento de la eficacia de vudalimab

Vudalimab, también conocido como XmAb20717, fue diseñado originalmente por Xencor, a biopharmaceutical company based in California. The clinical trial will measure the drug’s safety and efficacy, in an attempt to improve upon current immunotherapy options.

Working closely with MD Anderson’s mesotelioma specialists, Dr. Raghav and Dr. Anne Tsao, medical oncologist Dr. Arvind Dasari heads the clinical trial as the principal investigator. 

Phase II of this clinical trial aims to include 140 patients. Among these participants will be 20 patients with pleural mesotelioma, and 20 with peritoneal mesotelioma, in the hopes of establishing vudalimab’s efficacy in treating the asbestos-related cancer. Other cancers included in the trial include Hodgkin lymphoma, small cell lung cancer, cervical carcinoma, and neuroendocrine carcinomas. 

Los resultados prometedores de la fase I respaldan un mayor desarrollo de vudalimab

El ensayo clínico de fase I de vudalimab se centró principalmente en garantizar la seguridad, medir la tolerancia del paciente y determinar los niveles de dosificación óptimos para lograr la máxima eficacia. Los datos de este ensayo inicial indicaron que vudalimab generalmente se tolera bien y que múltiples tipos de tumores responden total o parcialmente a él. 

Menos toxicidad con vudalimab como agente único

The combination of Opdivo and Yervoy was approved by The US Food and Drug Administration as a first-line treatment for unresectable mesotelioma in 2020. 

Both drugs are classified as immune checkpoint inhibitors, with Opdivo targeting PD-1 cell surface proteins, while Yervoy targets CTLA-4. Newly developed Vudalimab has the ability to act as a ‘dual blockade agent,’ targeting both cell surface proteins, making it a promising advancement in mesotelioma treatment. 

The primary immunotherapy treatment option for mesotelioma is a combination of two drugs, Opdivo and Yervoy. According to researchers, vudalimab has the potential to improve upon the current results achieved with the current combination approach, but with fewer side effects, given that it will only require the administration of a single agent. 

Given that one of the primary outcomes of mesotelioma treatment is prolonging life and improving the overall quality of life, the introduction of a dual blockade, single-agent treatment has the potential to increase the success of these treatment goals. The more drugs administered, the more toxicities are introduced to the body, thus impeding the patient’s well-being. By treating mesotelioma with a single-agent approach, Vudalimab has the potential to offer an equal or improved efficacy with fewer side effects.

Ensayos clínicos

As an acclaimed cancer center, MD Anderson conducts multiple clinical trials related to mesotelioma, many of which are unique to the center and cover all disease stages, from early-stage to episodes of recurrence. You can visit the center’s website for obtener más información sobre los ensayos clínicos y los requisitos de elegibilidad. 

Types of mesotelioma

La mayoría de los casos de mesotelioma cases begin in the pleura (thin tissue layer covering the lungs and interior chest wall). This type is called malignant pleural mesotelioma.

Mesotelioma can also begin in the abdomen – malignant peritoneal mesotelioma – although this is rarer. Types of mesotelioma are also categorized depending on the type of mesothelial cells in which the disease begins. These are:

  • Epitelioide – accounting for 60-70% of cases, and often with the best prognosis
  • Sarcomatoide – more aggressive than epithelioid mesotelioma and accounting for around 10-15% of cases
  • Bifásico o mixto – the most aggressive form of mesotelioma, this type involves both epithelioid and sarcomatoid cells and accounts for 10-15% of mesotelioma casos

Treating mesotelioma

  • Cirugía – there are two main types of mesotelioma surgery; extrapleural pneumonectomy (removing the entire pleura) and pleurectomy/decortication (removing the affected areas of the pleura). Mesotelioma surgery rarely cures patients but is used to relieve síntomas y retrasar la progresión de la enfermedad.
  • Radioterapia – using high-energy beams, radiation therapy aims to kill cancer cells, particularly those left behind after surgery. Radiation therapy is also not a cure-all but can slow disease progression and improve symptoms
  • Quimioterapia – this is the primary treatment used for inoperable cases and has been proven to prolong the life of mesotelioma patients
  • Inmunoterapia – there are several types of immunotherapy that help the body’s immune system in different ways. Immune checkpoint therapy is the immunotherapy route for some mesotelioma patients. This therapy blocks checkpoint proteins from binding, thus preventing them from ‘switching off,’ allowing them to spend longer in cancer cell-killing mode

Pensamientos finales

The treatment of mesotelioma has always taken a combination approach for best results. However, recent research data demonstrates a compelling need for more focus on immunotherapy in mesotelioma patients, and vudalimab shows great promise in reducing the current side effects of the combination drug approach. 

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