Swiss researchers are developing a gel-based chemotherapeutic approach to treat malignant pleural mesothelioma. Initial results have suggested that delivering cancer-fighting drugs such as cisplatin bound with "natural glue" can be a toxicity free and efficient way to treat pleural disease.
In this project, researchers are combining the most commonly used drug to treat mesothelioma, cisplatin with fibrin. This combination is also known as "natural glue," when the tumor is stuck with this glue, cisplatin can function for more extended periods, thus reducing the chances of recurrence of the mesothelioma tumor.
While explaining the extensive research and treatment of mesothelioma at the University Hospital Zurich, the Lung and Thoracic Oncology Centre- LTOZ, Professor Isabelle Opitz and Dr. Michaela Kirschner gave insight about this project.
This institute caters numerous patients suffering from thoracic malignancies, as well as provide treatment to about 30-40 malignant pleural mesothelioma patients annually.
Need for Developing a Gel-Based Drug Delivery Method for Mesothelioma
Unfortunately, it is complicated to diagnose, check the tumor prognosis, and eventually, treat the metastatic mesothelioma tumor entirely. The most common chemotherapeutic drug for the treatment of mesothelioma is cisplatin (often called as CDDP by surgeons) along with pemetrexed (Alimta). Only about 40% of patients respond to this chemotherapy. However, surgical removal only guarantees a short-term solution, as the recurrence of the tumor within a year of treatment is the most common problem. All of these reasons reduce the survival rate of mesothelioma patients, demanding for a better therapeutic approach.
Testing Different Approaches to Increase the Efficiency of Chemotherapy
Researchers and doctors found another way to enhance the effectiveness of cancer-fighting drug cisplatin. To treat the patients of peritoneal mesothelioma and colorectal cancer, the doctors used intraperitoneal hyperthermic chemotherapy. In treatment, the patients were given chemotherapeutic drugs as per regular prescription. Additionally, the tumor area of the patients was rinsed with a heated chemotherapy solution after surgical procedure to kill residual tumor cells.
This treatment increased the survival of peritoneal mesothelioma patients. However, it did not prove to be useful for pleural mesothelioma patients. Regardless of decreasing the recurrence chances of the tumor, this procedure showed side effects for MPM patients such as kidney failure and renal toxicity.
Combination of Cisplatin and Fibrin, A Solution for Pleural Mesothelioma Treatment
The researchers concluded that the side effects of heated chemotherapy solution on pleural mesothelioma patients might be because of the excessive and fast absorption of cisplatin. To eradicate this problem, the researchers found the answer. The researchers wrote,
"We have developed in our laboratory a novel concept by binding Cisplatin to fibrin (Vivostat®) used as a carrier. Fibrin, a natural glue in our bodies, can be produced from fresh frozen plasma and using the Vivostat® System, this can be combined with your drug of choice and the resulting cisplatin-fibrin gel can be sprayed onto the desired area following tumor resection."
As per the animal study, the fibrin holds cisplatin at the spot without gearing up the absorption speed. Results showed not many kidney problems. Moreover, the cisplatin levels remained high for up to 70 days of surgical treatment.
What are the Benefits of using Fibrin to deliver Cisplatin?
In their published research, the Swiss scientists described the potential advantages of this method, writing,
"CDDP-fibrin can be used clinically as an alternative treatment option combined with less radical procedures such as pleurectomy/decortication for patients who are unlikely to benefit from an aggressive multimodal regimen (eg, patients with insufficient cardiopulmonary reserve, advanced age, or disease pattern)."
This advanced chemotherapeutic approach can be beneficial for patients who have not prescribed an aggressive surgical procedure. Moreover, if there are high chances of recurrence of tumor at specific places, then this method can be used right after the surgery.
"CDDP-fibrin can be used as an additional treatment option if, during radical surgery, zones potentially at risk for recurrence are identified."
The researchers will be testing this gel-based method on human mesothelioma patients. The researchers said,
“The study will also allow us to gather information about the clinical efficacy of the treatment,”