Malignant mesothelioma is a tumor for which there is currently no satisfactory treatment. Mesothelioma is an almost universally fatal disease, regardless of the stage of the tumor at the time of diagnosis. Current treatment modalities include surgery, chemotherapy and radiation therapy, although in some circumstances none of these modalities is superior to no treatment at all. A promising area of research in the treatment of various malignancies is gene therapy. Recent studies have demonstrated the utility of exposing tumor cells to cells transduced to express the Herpes simplex virus gene for thymidine kinase (HSV-TK). By virtue of their expression of HSV-TK, the transduced cells are rendered susceptible to the antiviral drug ganciclovir. Nearby untransduced cells are killed by a so-called bystander effect.
A Phase I clinical gene therapy trial for mesothelioma is underway at the Louisiana State University Medical Center of New Orleans. The purpose is to study the safety and to determine the maximal tolerated dose of an HSV-TK-transduced ovarian cancer cell line that is infused into the pleural cavities of patients. This infusion is followed by systemic administration of ganciclovir. The hope is that administration of ganciclovir will result in killing of both the transduced ovarian cancer cells as well as the nearby malignant cells. "Gene therapy for malignant mesothelioma: a novel approach for an incurable cancer with increased incidence in Louisiana", Schwarzenberger, et al., Journal of the Louisiana State Medical Society, 150(4):168-74, April 1998..
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