Moving beyond chemotherapy: novel cytostatic agents for malignant mesothelioma

It is now known that vascular endothelial growth factor (VEGF) and platelet derived growth factor (PDGF) are autocrine growth factors in malignant mesothelioma; epidermal growth factor receptor (EGFR) is also highly overexpressed. Cytotoxic drugs that target these growth factors offer fresh potential for the treatment of mesothelioma. Clinical trials have recently been initiated to evaluate the anti-tumour activity of the VEGF inhibitors SU5416, bevacizumab and thalidomide. ZD1839 (Iressa, AstraZeneca), an inhibitor of EGFR tyrosine kinase, is also being evaluated. Two clinical trials are planned to evaluate the two PDGF inhibitors Gleevec (Imatinib mesylate, STI-571, Novartis Pharmaceuticals) and PTK787 (Novartis Pharmaceuticals).