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Invited Commentary
January 2017

The ADAM Trial: Visiting the Road Less Traveled

Author Affiliations
  • 1Austin Health, Heidelberg, Australia
  • 2Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia
JAMA Oncol. 2017;3(1):66-67. doi:10.1001/jamaoncol.2016.2854

Until recently, cisplatin and pemetrexed disodium doublet chemotherapy was the only anticancer treatment with a median overall survival benefit in malignant mesothelioma.1 The MAPS study published in 2016 confirmed a modest improvement in median survival with the addition of bevacizumab to this regimen.2 Recent sequencing studies point to most mesotheliomas having a low mutational burden and few “druggable” oncogenes.3 However, with the rapidly expanding field of immuno-oncology, most of the recent excitement in mesothelioma research involves immune checkpoint inhibitors, with some encouraging results but also some disappointment. Despite the lack of oncogenic driver mutations, other mechanisms of “personalized medicine” are under investigation including antimesothelin antibody drug conjugates,4 vaccines, and small-molecule inhibition of growth factor receptors.5

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