Mesothelioma Update

By Mark Block, MD; and Alice M. Boylan, MD

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Gene Therapy

Molecular chemotherapy of mesothelioma is under study at two institutions in the United States. Investigators at the University of Pennsylvania instill an adenoviral vector containing the herpes simplex thimadine kinase (HSVtk) gene into the pleural space of patients.²⁷ This virus is taken up by mesothelial cells and the (HSVtk) gene product makes the cells metabolize ganciclovir to a toxic byproduct. In humans, the viral uptake is patchy, and repeated dosing is limited by the development of immunity to the virus. However, more recent results from the dose-escalation trial show promise. Investigators at Louisiana State University are using a similar strategy, but instead instill terminally irradiated ovarian cancer cells transfected with this gene.

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