Transarterial chemoperfusion shows promise for mesothelioma patients

A novel treatment for advanced mesothelioma is safe and effective and may improve the quality of life for patients who have few treatment options, according to a research abstract presented during a virtual session of the Society of Interventional Radiology's 2020 Annual Scientific Meeting on June 14. Transarterial chemoperfusion treatment for malignant pleural mesothelioma (MPM) comes with minimal side effects and shows promise for extending the lives of patients who have limited or no remaining treatment options.

"MPM is a devastating cancer of the pleura, the membranes surrounding the lungs, that is very difficult to treat," said Bela Kis, MD, PhD, the principal investigator on the study and an interventional radiologist at the Moffitt Cancer Center in Tampa. "The typical survival rate of patients with stage 3 and 4 MPM is around 12 months from diagnosis; but with this new treatment, we are hoping we might be able to extend patients' lives beyond that--giving them more time with friends and family."

Twenty-seven patients with MPM were enrolled in the Phase II clinical trial and underwent chemoperfusion treatment. All patients had received prior chemotherapy, many of whom received multiple lines of chemotherapy. Four of the patients had prior radiation therapy and three patients had pleurectomy. All continued to have disease progression before enrollment. 

Transarterial chemoperfusion delivers a relatively high concentration of drugs to diseased tissue in the lining of the lungs to maximize the treatment effect with limited side effects. Unlike other chemotherapy that is delivered intravenously and circulates through the entire body, interventional radiologists inject one-third of the chemotherapy cocktail of cisplatin, methotrexate, and gemcitabine directly into the internal mammary artery that supplies the pleura. The other two-thirds of the drugs are injected into the descending aorta, which reaches the intercostal vessels that also supply the pleura. The treatment is an outpatient procedure and typically lasts an hour, followed by a one-hour recovery.

The interim results of the study show 70.3 percent disease control rate and median overall survival rate of 8.5 months from the start of the chemoperfusion treatment. The treatment was well-tolerated by patients with a major complication rate of 1.4 percent. Most side effects were relatively minor, including mild nausea and chest pain.

"We were pleasantly surprised to find that this treatment doesn't come with the same side effects of traditional intravenous chemotherapy," said Kis. "To see these promising results with so few side effects means we are able to make a positive impact on quality of life for these patients."

Currently, surgery is the only truly effective treatment for MPM, but the disease must be diagnosed early. Unfortunately, only 10 to 20 percent of patients are candidates for surgery and often experience surgical complications. The researchers are looking to expand their study to other cancer centers with larger MPM patient populations, since the cancer is so rare. They also hope to add flexibility to the study to allow for increasing the dosage and changing the combination of medications for individual patients to determine whether either approach could further improve outcomes.

Additional information about the clinical trial is available at ClinicalTrials.gov, using the identifier NCT02611037

The research was originally scheduled to be presented in person at SIR's Annual Scientific Meeting, March 28-April 2, in Seattle before the meeting was canceled due to COVID-19 concerns. Visit sirmeeting.org for the latest information.

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New device shows promise in Type 2 diabetes treatment

Researchers have found that a newly tested medical device, called ‘Sleeveballoon’, mimics the effects of traditional bariatric surgery in rodents and produces impressive results on body weight, fatty liver and diabetes control.

Sleeveballoon is a device that combines a balloon with a connected sleeve, which covers the initial parts of the small intestine. It is inserted into the stomach and bowel during minimally invasive surgery under general anaesthetic.

For the study, researchers compared the effects of the Sleeveballoon and traditional bariatric surgery on 30 rodents fed with a high-fat diet, achieving very similar results.

Results were also compared to rats, with the new device reducing food intake by 60 per cent and resulting in a 57 per cent reduction in fat mass.

The effect on diabetes was similarly impressive with blood glucose levels dropping by 65 per cent.

“Gastric bypass surgery is a highly effective treatment of obesity and type 2 diabetes. However, very few eligible patients, only around one per cent, are offered surgery and some also prefer less invasive approaches,” said study’s lead author.

“However, while gastric bypass causes a rapid rise in post food blood glucose levels which can cause hypoglycaemia, the Sleeveballoon induces a slowing down of digestion which has a steadying effect on blood sugar levels,” the author said.

“This helps control appetite and hunger, keeping the person fuller for longer and substantially reduces weight,” he added.


During the study, the research team found that the metabolic effects of the Sleeveballoon device are similar to those of the gastric bypass but have distinct advantages over the traditional method.
In both, insulin sensitivity and heart functions improved.

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Scientists have found out how immune system can learn to recognise and fight cancers

Immunotherapy has shown great promise as a new type of treatment for cancer.

 Scientists from the University of Southampton in a latest study have discovered an important way in which the immune system can learn to recognise and fight cancers. The study, published in Proceedings of the National Academy of Sciences of the USA, shows that ‘Akt’ is critical for survival of T cells when they turn into memory cells and for how these can then react to future threats. The team, led by Professor Aymen Al-Shamkhani, a Professor of Immunology at the University of Southampton, and funded by Cancer Research UK, has shown that a protein called Akt, is vital for the way the body remembers a cancer it has eradicated. The body’s immune system includes cytotoxic T cells, which actively seek out and destroy infections or cancers. When they have dealt with the danger, the majority of T cells die, but the remaining ones turn into memory cells, which can recognise the threat if it comes back. However, how this actually works has previously not been clear. The Southampton team has found that a protein called Akt has a big effect on the number and type of memory T cells that a danger signal can generate. Professor Al-Shamkhani says that: “If we can harness Akt to boost the memory cells in numbers and ability we could offer more protection against cancer.”

He added: “Immunotherapy has shown great promise as a new type of treatment for cancer, but we need to find ways to improve the body’s immune memory for cancer cells. If we can get the body’s immune system to recognise cancers faster and better, that will be a big help in finding more effective treatments.” Dr Justine Alford, senior science information officer at Cancer Research UK, says: “By revealing more about how the immune system learns to recognise and attack cancers, this laboratory study may have identified a way to make immunotherapy more effective and longer-lasting. The next step will be to see if this approach works, and is safe for patients.” Over the past 40 years the University of Southampton has made a number of advances in cancer immunology and immunotherapy research, with a reputation for its ‘bench to bedside’ results. This year, the University will open The Centre for Cancer Immunology. It is the first of its kind in the UK and will bring world leading cancer scientists under one roof and enable interdisciplinary teams to expand clinical trials and develop lifesaving drugs.

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