Guazzelli Alice, Bakker Emyr, Tian Kun, Demonacos Constantinos, Krstic-Demonacos Marija, Mutti Luciano
a Biomedical Research Centre, School of Environment and Life Sciences , University of Salford , Salford , UK.
b School of Health Sciences , University of Manchester , Manchester , UK.
Expert Opin Investig Drugs. 2017 Aug;26(8):933-944. doi: 10.1080/13543784.2017.1351545. Epub 2017 Jul 12.
Malignant mesothelioma is a rare and lethal malignancy primarily affecting the pleura and peritoneum. Mesothelioma incidence is expected to increase worldwide and current treatments remain ineffective, leading to poor prognosis. Within this article potential targets to improve the quality of life of the patients and assessment of further avenues for research are discussed. Areas covered: This review highlights emerging therapies currently under investigation for malignant mesothelioma with a specific focus on phase I and phase II clinical trials. Three main areas are discussed: immunotherapy (immune checkpoint blockade and cancer vaccines, among others), multitargeted therapy (such as targeting pro-angiogenic genes) and gene therapy (such as suicide gene therapy). For each, clinical trials are described to detail the current or past investigations at phase I and II. Expert opinion: The approach of applying existing treatments from other cancers does not show significant benefit, with the most promising outcome being an increase in survival of 2.7 months following combination of chemotherapy with bevacizumab. It is our opinion that the hypoxic microenvironment, the role of the stroma, and the metabolic status of mesothelioma should all be assessed and characterised to aid in the development of new treatments to improve patient outcomes.
恶性间皮瘤是一种罕见的致命性恶性肿瘤，主要累及胸膜和腹膜。预计全球范围内间皮瘤的发病率将会上升，而目前的治疗方法仍然无效，导致预后较差。本文讨论了改善患者生活质量的潜在靶点以及进一步研究途径的评估。涵盖领域：本综述重点介绍了目前正在研究的针对恶性间皮瘤的新兴疗法，特别关注I期和II期临床试验。讨论了三个主要领域：免疫疗法（如免疫检查点阻断和癌症疫苗等）、多靶点疗法（如靶向促血管生成基因）和基因疗法（如自杀基因疗法）。针对每个领域，描述了临床试验，以详细说明I期和II期目前或过去的研究情况。专家意见：应用其他癌症的现有治疗方法并未显示出显著益处，最有前景的结果是化疗联合贝伐单抗后生存期延长2.7个月。我们认为，应评估和表征间皮瘤的缺氧微环境、基质的作用以及代谢状态，以帮助开发新的治疗方法来改善患者预后。
