First Southampton patient enters trial to personalise treatment for asbestos-linked cancer
The first Southampton patient in a new trial says he’s looking forward to ‘flying the flag’ for research into mesothelioma.
Mesothelioma is an aggressive cancer linked to asbestos exposure.
The SELECTmeso1 trial is investigating a new personalised treatment for patients with mesothelioma whose cancer has returned after initial treatment. This could potentially give them more time with their loved ones.
The study is being run by the Cancer Research UK Southampton Clinical Trials Unit (SCTU). It is being delivered in partnership with the Southampton and Leicester NIHR Biomedical Research Centres.
Researchers recently started recruiting patients at University Hospital Southampton (UHS). 75-year-old grandfather Dave Young is the first patient in the South to be enrolled in the trial.
Tailoring treatments
Mesothelioma is a cancer that forms in the lining of the lungs or abdomen. It is linked to exposure to dangerous asbestos fibres.
Around 2,700 people are diagnosed with the disease each year. However, there are currently very few treatment options.
Outcomes and survival rates are poor, and the cancer will often return after initial treatment. Only around five percent of people diagnosed with the disease will survive for five years or more.
Recent mesothelioma trials have been conducted by the SCTU with partners at the Southampton and Leicester NIHR Biomedical Research Centres.
They have shown targeted treatments can improve survival for people with relapsed mesothelioma, where the disease has come back. However, these treatments often only work for some patients but not for others.
SELECTmeso1 will test whether a targeted cancer treatment can improve outcomes for patients with the disease who have a particular genetic biomarker. Funded by Asthma + Lung UK, the trial initially opened in Leicester earlier this summer.
Professor Gareth Griffiths is Director of the SCTU and co-Chief Investigator of the SELECTmeso1 trial. He is also part of the Respiratory and Allergy theme at the NIHR Biomedical Research Centre: Southampton.
“Whether a particular treatment is effective could be down to the specific genetic signals, or biomarkers, present in the cancer, which are often different between individual patients,” he said.
“If we can identify which biomarkers each patient has, then we may be able to personalise the care they get, giving them best chance of successful treatment. This is precisely what the SELECTmeso1 trial is designed to do.”
Promising anti-tumour activity
Almost half of patients with mesothelioma are missing a particular gene called MTAP. This means the cancer is more aggressive and doesn't respond as well to existing treatments.
The SELECTmeso1 team are working with pharmaceutical company Bristol Myers Squibb, who have developed a drug called Navlimetostat. This targets the weak point created by the absence of the MTAP gene. It selectively kills those cancer cells, leaving the healthy cells largely unaffected.
“This drug has already been trialled in some other cancers and has been shown to have promising anti-tumour activity,” says Professor Griffiths.
“It was also well tolerated by patients without causing too many side effects. Through the SELECTmeso1 trial, we therefore hope to find out whether this could be a viable treatment for patients with this specific genetic signal.
“If we find evidence that patients benefit, this will hopefully lead to future larger practice-changing trials.”
First patient in the South
Dave Young is a retired engineer who lives in Langley in Hampshire. He went to his doctor in October 2024 after experiencing breathing difficulties while walking on holiday.
After procedures to drain fluid from his lungs and several tests, he was diagnosed with terminal pleural mesothelioma.
“You feel nothing else but numbness, a finality,” says Dave. “You come back home, there’s sleepless nights, because your whole world is spinning. It’s debilitating.
“Anything which is too physical or exerts too much has just got to go, and at first that’s hard to deal with, because the things you love doing you can no longer do.”
Dave was treated with immunotherapy and chemotherapy, but after that there were no treatment options left.
“My wife’s very positive,” he said. “She used to research these things and there are trials around. There was a proton beam treatment a while back, so I would ask the nurse if I would be ok for that, but she would say unfortunately not as I’d already had immunotherapy and chemotherapy.
“But then eventually she said to me, there’s a trial which probably would be suitable for you. So, I said let’s see how we go then, and it came back that yes, I was suitable. So, flying the flag, here I am and I’m looking forward to it.”
Patients like Dave, who have relapsed mesothelioma and are found to have the deleted MTAP gene, will be invited to join the trial.
They will be given the targeted treatment in the form of tablets every day, in three-weekly cycles, for up to six months. The research team will monitor how much their tumour shrinks, as well as any side effects they experience.
Dr Judith Cave, Medical Oncology Consultant, is leading recruitment at UHS.
“It is fantastic to be able to offer this trial to patients here in the South who have not responded to other treatments and have seen their cancer return,” she said.
“Not all mesothelioma patients will be eligible to join this particular trial, as it is targeting those with the specific deleted MTAP gene. But we do know that more treatments which target other genes are being developed all the time, and it is exciting that SELECTmeso1 is the just the start for trials that could see a more personalised approach for mesothelioma patients.”
Looking for more targets
SELECTmeso1 is the first trial in a much larger planned platform clinical trial run by the SCTU at the University of Southampton.
This aims to test several targeted drugs, which work against different genetic biomarkers that may be present in a patient’s mesothelioma.
Dr Emma Knox is Senior Trial Manager for SELECTmeso at the SCTU. She said:
“The idea of the platform trial is that we can run several different trials at once, giving patients more chance of receiving a treatment that works for them.
“Once the full platform is open, patients will be invited to join, and will have a sample of their cancer tested in a laboratory. This will tell doctors about the particular genetic make-up of their cancer and what biomarkers their mesothelioma has.
“If there is a trial within the platform that is testing a drug that works specifically for that biomarker, they will be invited to join that particular trial.”
If there is no trial running for that biomarker at that time, patients will remain in the platform database. They will be contacted if a new trial of a treatment that may work for them comes on board.
Dr Samantha Walker is Director of Research and Innovation at Asthma + Lung UK, who is funding the trial. She said:
“Asthma + Lung UK is proud to be funding this vital research, which could be a real breakthrough and has the potential to improve the lives of people living with mesothelioma.
“With life expectancy remaining low and no current cure available, progress on treating this devastating condition is desperately needed.
“Targeted therapy has already shown to be effective for other types of cancer. If this trial is successful, it would offer new hope for the more than 2,000 people who are diagnosed with mesothelioma every year.
“Cutting-edge research into new types of treatment for lung conditions is vital to improve health outcomes but funding for lung health research is currently on life-support, despite lung conditions remaining the third biggest cause of death in the UK.”
Professor Griffiths continues: “The aim of SELECTmeso1, and the wider trial platform, is to see whether stratifying treatment in this way can improve outcomes for patients.
“If our trials can provide that evidence, we hope that in the future doctors treating people with this aggressive cancer will be able to use a more personalised approach, selecting the best possible treatment for each individual patient.”
Dave is positive about taking part in the trial.
“The thing with research is it might work, it might not, you don’t know,” he said. “But I think you have to look further down the line and say well, whatever the outcome is there will be lessons to be learned from it.
“I’m quite happy to be involved with it, even if it does nothing for me, there will be things to be learned for future trials. And the on other hand, there is no alternative, so you just have to do it.”