Since the news broke from American Research Association Cancer Conference about Niraparib lots of patients who are coming to the end or who have already reached the end of any active treatment for their mesothelioma have been asking lots of questions.

Niraparib is a drug which is in a class of drug known as PARP inhibitors which work by blocking the repair of damaged DNA in cancer cells, thereby causing the cancer cells to die. 

PARP inhibitors have already been shown to improve the survival of patients with some types of breast and ovarian cancers. A previous study had also shown that mesothelioma does respond to this type of drug, but more evidence was needed as to whether it could improve outcomes for patients. 

Some 88 patients whose mesothelioma treatment had stopped working took part in the trial at 11 hospitals across the UK. Those given a PARP inhibitor called niraparib were found to have a 27% reduction in the risk of the cancer progressing or death. This delayed the worsening of mesothelioma by an average of 1.5 months compared to those receiving the standard of care treatments, with a number of patients seeing a much longer period of time where their cancer was under control.

Out of the 88 patients recruited to take part in the trial 56 patients received Niraparib and the remaining 28 patients had active symptom control, that is they received treatment for symptoms but not the cancer. Compared to many other clinical trials in mesothelioma this was a very small trial.

Niraparib does have side effects many of which are similar to chemotherapy and in rare cases some patients noticed problems that affected their brain such as headaches and fitting.

As far as I am aware Niraparib is not available on the NHS for mesothelioma patients and it will be interesting to see if an application is submitted to NICE for this drug to be made available on the NHS.

My advice would be to discuss the NERO Trial with your oncologist and if you have the option of private treatment you could also explore whether this drug would be suitable for you in the private setting. Either way your treating oncologist is best placed to assess if Niraparib would be a safe treatment option as they know your medical history and have the knowledge and expertise to make these decisions.

On a positive note Professor Griffiths who led on the NERO Trial is already preparing to open a new trial to mesothelioma patients who have already received treatment for mesothelioma. This trial is called SELECTmeso and we await news that this trial is open for recruitment. There are other trials ongoing using new drugs which we are awaiting results for so it is good to see a continued enthusiasm in the search for effective drug treatments for mesothelioma patients. This year sees the International Mesothelioma Interest Group conference in October where experts from all over the world come together to share research on innovations and treatments in mesothelioma. I look forward to attending and bringing back highlights to share with all HASAG patients.

Further information on Niraparib can be found on the Macmillan website and by following the link below:

https://www.clinicaltrialsarena.com/news/zejula-mesothelioma-trial-efficacious/?cf-view&cf-closed