One drug studied in a recent clinical trial is being described as a breakthrough in the treatment of mesothelioma, a rare cancer caused by asbestos exposure.

The two-year ATOMIC-Meso trial explored the effectiveness of pegargiminase (ADI-PEG20), a drug that restricts the body from producing a certain amino acid that fuels mesothelioma cancer growth.

After the third phase of the trial, the drug had successfully:

  • Helped patients live longer with minimal side effects
  • Quadrupled 3-year survival rates
  • Stopped cancer progression for over 6 months

These results move the drug closer to final approval by the U.S. Food and Drug Administration (FDA) as the first new mesothelioma chemotherapy treatment in decades.

Find out more about the groundbreaking ATOMIC-Meso clinical trial and its promising results now.

Understanding ADI-PEG20 and the ATOMIC-Meso Trial

Dr. Peter Szlosarek of Queen Mary University of London has researched a protein called ASS1 for over 20 years. He was the first to discover that mesothelioma cells lack ASS1 and therefore can’t produce their own arginine, an essential nutrient for cancer cell survival. As a result, mesothelioma must rely on arginine in the bloodstream to grow.

Dr. Szlosarek sought to create a new therapy that could remove arginine from the blood and essentially starve cancer cells of their food supply. ADI-PEG20 is the culmination of Dr. Szlosarek’s decades-long research.

“It’s truly wonderful to see the research into the arginine starvation of cancer cells come to fruition. This discovery is something I have been driving from its earliest stages in the lab, with a new treatment, ADI-PEG20 (pegargiminase), now improving patient lives affected by mesothelioma.”

- Dr. Peter Szlosarek

The purpose of the ATOMIC-Meso trial was to see how mesothelioma patients would respond to ADI-PEG20 when it was administered with chemotherapy.

Half of the trial participants received weekly injections of ADI-PEG20, and the other half received a placebo. The patients who got ADI-PEG20 were also given a combination of the chemotherapy drugs pemetrexed and cisplatin or carboplatin every 3 weeks for 6 cycles.

Get the latest information on treatment options and clinical trials in our Free Mesothelioma Guide.

About the Phase III ATOMIC-Meso Trial Participants

Scientists describe ATOMIC-Meso as the largest trial of its kind, involving:

  • 206 men and 43 women diagnosed with pleural mesothelioma
  • Researchers from 43 hospitals and medical institutions
  • 5 countries including the U.K., U.S., Australia, Italy, and Taiwan

Each of these patients had nonepithelioid mesothelioma, a rare subtype of this cancer that is more resistant to treatment and spreads to other organs much more quickly than epithelioid mesothelioma. The average life expectancy for patients with this subtype is only 4 months.

However, researchers were hopeful for improved survival in patients who took ADI-PEG20.

ADI-PEG20 Produces Encouraging Results

Researchers were pleased to find that the combination of pegargiminase and chemotherapy had positive results for patients.

The ATOMIC-Meso trial found patients who received ADI-PEG20:

  • Extended their life expectancy by 1.6 months
  • Were 4 times more likely to survive for 3 years following treatment
  • Experienced 35% less risk of cancer progression

The results of the ATOMIC-Meso trial indicate that pegargiminase is a promising treatment for pleural mesothelioma, the most common type of this cancer. The drug was also well tolerated, with most patients only experiencing mild side effects like nausea and fatigue.

One mesothelioma patient enrolled in the clinical trial after being told he only had 4 months to live. He’s now a 5+ year survivor.

“This trial has changed the lives of people with mesothelioma, allowing us to live longer. I have five grandchildren and two great-grandchildren now — I wouldn’t want to miss all that.”

- Patient enrolled in ATOMIC-Meso trial

Mesothelioma Hope can help you find clinical trials in your area so you can access the latest emerging treatments and increase your chances of survival. Call (866) 608-8933 now to get started.

Get Help Finding Mesothelioma Treatment

In recent years, mesothelioma treatment advances have helped many patients far surpass their life expectancy. With this new drug, even more options may be available in the near future.

If you or someone you love has been diagnosed with mesothelioma, our team can help you get the personalized care and support you need.

Our Patient Advocates at Mesothelioma Hope can help you:

  • Find a mesothelioma doctor near you
  • Help you enroll in clinical trials for mesothelioma
  • Understand your treatment options and potential side effects
  • Connect you with peer mentors who have also faced mesothelioma

Call a Patient Advocate now at (866) 608-8933 or get the latest information on treating this cancer in our Free Mesothelioma Guide.

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Laura WrightWritten by:

Lead Editor

Laura Wright is a journalist and content strategist with more than 15 years of professional experience. She attended college at the University of Florida, graduating magna cum laude with a bachelor’s degree in journalism in 2008. Her writing has been featured in The Gainesville Sun and other regional publications throughout Florida.

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  1. The Guardian. (2024, February 15). Drug offers ‘wonderful’ breakthrough in treatment of asbestos-linked cancer. Retrieved from: Accessed on February 23, 2024.
  2. Queen Mary University of London. (2023, April 16). Clinical trial shows tumour-starving drug improves survival of mesothelioma. Retrieved from: Accessed on February 23, 2024.
  3. Szlosarek, Peter; Creelan, Benjamin; Sarkodie, Thomas. JAMA Oncology. (2024, February 15). Pegargiminase Plus First-Line Chemotherapy in Patients With Nonepithelioid Pleural Mesothelioma. Retrieved from: Accessed on February 23, 2024.

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