"I am glad that taking part in a trial might help others on their own cancer journey.”
A trial of defactinib (VS-6063) for pleural mesothelioma (COMMAND)
Please note - this trial is no longer recruiting patients. We hope to add results when they are available.
This trial is looking at a drug called defactinib to treat mesothelioma that started in the sheets of tissue covering the lungs (pleural mesothelioma).
Unfortunately, it can be difficult for doctors to treat pleural mesothelioma. You may have chemotherapy, but researchers are looking for ways to improve treatment. In this trial, they are looking at an experimental drug called defactinib.
Defactinib is a type of biological therapy. It stops signals that mesothelioma cells use to divide and grow.
The trial is comparing defactinib with a dummy drug (
- Find out if defactinib helps people with pleural mesothelioma more than a dummy drug
- See what effect it has on peoples’
quality of life
Who can enter
You may be able to enter this trial if
- You have been diagnosed with pleural mesothelioma
- There is a sample of your tumour available (or you are willing to have a
biopsyto obtain a sample)
- You have had treatment with the chemotherapy drugs pemetrexed and either carboplatin or cisplatin and you have had at least 4 treatment cycles
- Your chemotherapy treatment finished in the last 6 weeks and your mesothelioma stayed the same size or got smaller
- You have recovered from the side effects of chemotherapy unless they are very mild
- You are able to care for yourself, even if you can’t carry on with normal activities or active work (Karnofsky performance status of at least 70)
- You have satisfactory blood test results
- You are at least 18 years old
- You are willing to use reliable contraception during the trial and for 3 months afterwards if there is any chance you or your partner could become pregnant
You cannot enter this trial if you
- Have cancer that has spread to your brain, unless this has been treated and if you take steroids or medication to prevent fits (seizures), your dose hasn’t changed in the last 4 weeks
- Have had any chemotherapy drugs other than pemetrexed with cisplatin or carboplatin
- Have already had a drug that works in a similar way to defactinib – the trial team can advise you about this
- Have had another experimental drug in the last month
- Have a problem with your
digestive systemthat could affect you swallowing or absorbing tablets
- Have had an ulcer or bleeding in your gut in the last year
- Have had major surgery in the last 4 weeks
- Have had a stroke in the last 6 months
- Have a condition in which there is build up of a pigment called bilirubin making your skin or the whites of your eyes look yellow (Gilbert’s syndrome)
- Have a serious infection
- Have had a heart attack in the last 6 months or have certain other heart problems – the trial team can advise you about this
- Are known to be HIV positive or to have hepatitis A, B or C
- Have a mental illness that would make it difficult for you to take part
- Have had any other cancer in the last 5 years apart from carcinoma in situ of the cervix or non melanoma skin cancer that was successfully treated
- Are pregnant or breastfeeding
This international phase 2 trial aims to recruit over 370 people.
It is a randomised trial. The people taking part are put into treatment groups by a computer. Neither you nor your doctor will be able to decide which group you are in.
- People in 1 group take defactinib tablets twice a day
- People in the other group take dummy tablets (
The trial team will ask you to keep a diary at home. In this, you write down when you take your tablets each day.
As long as you don’t have bad side effects, you can carry on having the trial treatment for as long as it helps you.
During the trial, the researchers will take some extra blood samples to see what happens to the drug in your body. This is called
The trial team will ask you to fill out a questionnaire before you start treatment, at each hospital visit during treatment and after you finish treatment. The questionnaire will ask about side effects and how you’ve been feeling. This is called a quality of life study.
You see the trial team and have some tests before you start treatment. The tests include
- Physical examination
- Blood tests
- Urine tests
- Heart trace (
- CT scan
The trial team will get a sample of your cancer that was removed when you had a
During treatment, you go to see the trial team every 3 weeks for the first 6 months and then every 4 weeks after that. You have regular blood tests and a CT scan or X-ray every 6 to 8 weeks.
When you stop taking the tablets, you see the trial team a week later and again a month later. After that, they will contact you by phone every 2 months to see how you are.
As defactinib is a new drug, there may be side effects we don’t know about yet. In trials so far, the most common side effects have been
- Diarrhoea or constipation
- Feeling or being sick
- Loss of appetite
- Tiredness (fatigue)
- Changes to your liver
- High temperature (fever)
- Cough or shortness of breath
- Chest pain
- Back or joint pain
- Sore throat
- High blood pressure
Defactinib may affect your ability to have a child (your fertility). It can also make you more sensitive to sunlight. During the trial, you must reduce your exposure to the sun, use sunscreen and wear sunglasses whenever you are in the sun.
How to join a clinical trial
Professor Dean Fennell
Experimental Cancer Medicine Centre (ECMC)
NIHR Clinical Research Network: Cancer