Pegargiminase in addition to pemetrexed and cisplatin for advanced malignant pleural mesothelioma – first line

Pegargiminase is a medicinal product currently being developed to be given in addition to pemetrexed and cisplatin for the treatment of advanced malignant pleural mesothelioma. Malignant pleural mesothelioma is rare a type of cancer that affects the outer linings of the lungs and the internal chest wall. Mesothelioma is often diagnosed at an advanced stage. Malignant pleural mesotheliomas are most often surgically unresectable, and they respond poorly to current chemotherapy and radiation therapy.
Pegargiminase is administered by intramuscular injection and works by depleting the external supply of an amino acid called arginine. External supply of arginine is critical for the survival of mesothelioma cell lines that are deficient with an enzyme called ASS1. Depletion of external supply of arginine will lead to death of cancer cells that are arginine-dependent while leaving the patient's normal cells unharmed and may block the growth of cancer cells that need arginine to grow. If licensed, pegargiminase in addition to pemetrexed and cisplatin will offer a new first line treatment option for patients with advanced malignant pleural mesothelioma with low ASS1 expression.