Nicholas J. Vogelzang, MD
Nintedanib, an angiogenesis inhibitor, is being investigated as a first-line treatment for patients with unresectable malignant pleural mesothelioma (MPM). Although it is estimated that malignant mesothelioma represents less than 1% of all cancers, it is a fatal asbestos-associated malignancy1
, and patients with MPM tend to be difficult to treat.
Figure. Nintedanib in Malignant Pleural Mesothelioma
The FDA has approved nintedanib under the trade name Ofev for the treatment of idiopathic pulmonary fibrosis. As a small-molecule, nintedanib binds competitively to the ATP binding pocket of the VEGF and PDGF receptors, blocking intracellular signaling needed for the proliferation, migration, and transformation of fibroblasts that are essential to the growth of MPM. It also inhibits the Lck, Lyn, and Src nonreceptor tyrosine kinases.3
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