Personalised cancer treatment makes headway for mesothelioma patients with support from Victor Dahdaleh Foundation

A University of Leicester and University Hospitals of Leicester NHS Trust study shows promising results using rucaparib to treat mesothelioma in patients where chemotherapy has not been effective in controlling the disease. 

The clinical trial, funded by the British Lung Foundation and the Victor Dahdaleh Foundation, is investigating personalised treatments for mesothelioma, a cancer most commonly caused by exposure to asbestos.

Initial results from arm one of the Mesothelioma Stratified Therapy (MiST) trial, led by Professor Anne Thomas, showed a disease control rate (DCR) of 57.7% (95% CI, 36.9 – 76.7) at 12 weeks. This demonstrates a promising efficacy and with manageable toxicity from treatment.

Rucaparib is a PARP inhibitor. PARP are enzymes that repair damaged DNA in cancer cells and, inhibition of PARP results in an inability of cancer cells to repair therefore causing these cancer cells to die. It is currently used to treat ovarian, fallopian and peritoneal cancers. The use of rucaparib as a treatment in arm one of the MiST trial follows on from earlier pre-clinical research at Leicester funded by the British Lung Foundation. These recent results confirm activity of PARP inhibitors in mesothelioma, therefore validating this earlier finding.

Every year in the UK, approximately 2,700 people are diagnosed with mesothelioma and around 2,500 die from the disease. Pleural mesothelioma is a type of cancer that mainly affects the lining of the lungs and has a one-year survival rate of only 38%. Mesothelioma can take several decades to develop with some patients only experiencing symptoms when the disease reaches an advanced stage. There is no cure for mesothelioma.

Chemotherapy has been the only approved standard treatment for more than a decade and is capable of controlling mesothelioma for only a limited time. Recently it has been found that mesotheliomas differ genetically between patients, and this finding raises the hope that personalised treatments may be found that are more effective and less toxic.

The MiST trial is the world’s first molecularly stratified trial that is designed to identify first signals of treatments working well and to support development of new, promising medicines for mesothelioma. The trial is split into multiple arms, with patients being screened for genetic markers in their tumours in order to identify the treatment likely to have the best results, known as personalised medicine. They are then allocated to this trial arm for treatment. Funding MiST is made possible thanks to a generous £5 million donation by the Victor Dahdaleh Foundation to the British Lung Foundation for mesothelioma research programmes.

These results, being presented virtually at the American Society of Clinical Oncology’s annual conference, are from arm one of the study, but there are a further three arms, each examining different drugs. MiST arms two and four are ongoing in Leicester and Newcastle hospitals, and arm three is due to open imminently. It was recently confirmed that further funding has been leveraged from the pharmaceutical industry to enable a new arm of the trial – arm 5. The funding is accompanied by free use of the treatment drugs, up to the value of £2 million.

Professor of Cancer Therapeutics at the University of Leicester, Anne Thomas, said: ‘Mesothelioma is a devastating disease for patients and their families with very limited treatment options. The whole team is excited that this novel targeted therapy approach, developed in Leicester, looks promising and we look forward to continuing the programme of work.’

Dr Samantha Walker, Director of Research and Innovation at Asthma UK & British Lung Foundation, said:  ‘We are delighted to see the first results from the phase 2 MiST trial, indicating rucaparib can lead to control of the disease for 12 weeks in people with mesothelioma where chemotherapy is ineffective. As there is currently no recommended treatment for people who are not responding to first line therapy, these results are highly encouraging. Mesothelioma remains a devastating disease that wreaks havoc for thousands of families in the UK and we are proud of the British Lung Foundation’s long history of funding high-quality research to understand the condition and develop new treatments to improve the lives of those affected. 

Victor Dahdaleh, commenting on behalf of the Victor Dahdaleh Foundation, said: ‘The Foundation is delighted to be supporting this vital project and to have acted as a catalyst for a variety of matched funding, which is always one of our aims.  It is very encouraging to see the initial publication of these results. We are also pleased to see that our support of the innovative MiST trial approach has now garnered welcome funding from the pharmaceutical industry for arm 5 of the trial. Encouraging cross-industry collaboration was always part of our ambition for this programme and it is positive to see it happening in such a practical way.’

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Notes to editor:

More information about the clinical trial: https://clinicaltrials.gov/ct2/show/NCT03654833

For more information on mesothelioma and support provided by the British Lung Foundation: https://www.blf.org.uk/support-for-you/mesothelioma/what-is-it

Survival rates and statistics can be found in the ‘National Mesothelioma Audit Report 2018’, available: https://www.rcplondon.ac.uk/projects/outputs/national-mesothelioma-audit-report-2018-audit-period-2014-16

More information on rucaprarib is available from the BNF:  https://bnf.nice.org.uk/drug/rucaparib.html

For more information, please contact Heather Gordon (Communications Officer) at Asthma UK & British Lung Foundation on 07983 080793.

For more information about the Victor Dahdaleh Foundation, please contact Matthew Moth at Madano on 020 7593 4000 or 07770 381 263.

About the British Lung Foundation:

British Lung Foundation is the only UK charity fighting to help the 1 in 5 people in the UK affected by lung disease.

We fund world leading research, provide support and information to people with lung conditions and campaign for better diagnosis, treatment and prevention.

For further information, please visit www.auk-blf.org.uk For help and support, call the BLF Helpline on 03000 030 555.

About the Victor Dahdaleh Foundation

The Victor Dahdaleh Foundation is a global charitable organisation focused on health, education and social & economic development.

Founded by Canadian businessman and philanthropist Victor Dahdaleh, the Victor Dahdaleh Foundation supports education, health and social development programmes around the world, taking an active role in the initiatives it funds. As a Canadian and an alumnus of York and McGill universities in Canada, Victor Dahdaleh also promotes closer ties between Canada and the UK through the work of the Foundation.

The Foundation funds a wide range of academic research into areas such as neuroscience and cardiovascular disease, as well as broader global issues with health implications such as migration and the environment.

For more information on the work of the Victor Dahdaleh Foundation visit our website at victordahdalehfoundation.com or LinkedIn.

About the University Hospitals of Leicester NHS Trust

University Hospitals of Leicester NHS Trust is one of the biggest and busiest NHS Trusts in the country, serving the one million residents of Leicester, Leicestershire and Rutland – and increasingly specialist services over a much wider area. Our nationally and internationally-renowned specialist treatment and services in cardio-respiratory diseases, ECMO, cancer and renal disorders reach a further two to three million patients from across the UK.

Spread over the General, Glenfield and Royal Infirmary hospitals, we also have our very own Children’s Hospital and work closely with partners at the University of Leicester and De Montfort University providing world-class teaching to nurture and develop the next generation of over 15,000 highly skilled staff including doctors, nurses and other healthcare professionals, many of whom go on to spend their working lives with us. For further information, please visit www.leicestershospitals.nhs.uk

About the University of Leicester

The University of Leicester is led by discovery and innovation – an international centre for excellence renowned for research, teaching and broadening access to higher education. It is among the top 25 universities in the Times Higher Education REF Research Power rankings with 75% of research adjudged to be internationally excellent with wide-ranging impacts on society, health, culture, and the environment. The University is home to just over 20,000 students and approximately 3,000 staff.Find out more: https://le.ac.uk/about