| Bevacizumab (Avastin) | Monoclonal antibody vascular endothelial growth factor receptor agonist; angiogenesis inhibitor | Proven efficacy in lung, colon, breast cancer. Multicentre trial underway adding bevacizumab to gemcitabine and cisplastin | 126 |
| Ranpirnase (Onconase) | Anti-tumour ribonuclease | Phase III trial of doxorubicin with or without ranpirnase nearly complete. Statins may reverse doxorubicin resistance | 127 |
| Bortezomib (Velcade) | Proteosome inhibitor | Proven efficacy in myeloma. Phase II (randomised) trial underway in mesothelioma | 128 |
| Arginine depletion | Argininosuccinate synthetase, a rate-limiting enzyme in arginine production is deficient in >50% of mesotheliomas | Phase II clinical trial planned | 129 |
| Immunotherapy | Newer targeted biological agents are under development | Interleukin-2 and interferon disappointing | 130 |
| Gene therapy | Attractive concept but unlikely to be able to eradicate a solid tumour diagnosed late in natural history | Gene therapy no practical use outside small trials. Role may be as part of multi-modality treatment | 131 |