In this Opinion piece, Nicola Dawn, a Partner in the Insurance Team at Forbes Solicitors, looks at the potential impact of a new mesothelioma drug on asbestos liability claims.
Mesothelioma is a cancer linked to asbestos exposure and is notorious for being difficult to treat. The cancer commonly develops in the lining that covers the outer surface of the lungs, but can also affect the lining of other organs including the heart, stomach, and testicles. It’s the spread across surfaces, nerves and blood vessels that make it hard to target in the same way that other cancer treatments may focus on the growth of a tumour.
This type of cancer is incurable and can be caused by inhaling microscopic asbestos fibres and dust. It usually takes a long period for mesothelioma to show any obvious problems, with the NHS reporting that the cancer can develop more than 20 years after exposure to asbestos.
In recent clinical trials spanning five countries, a new drug ADI-PEG20 (pegargiminase), incorporated with chemotherapy, was found to effectively stop mesothelioma cancer cells from absorbing the amino acid arginine, which usually helps the body build protein. Essentially, this means that the new drug can block the cancer’s food supply, helping to hinder the growth and spread of cancerous cells.
The results from the trials are being hailed as the biggest mesothelioma breakthrough in two decades and could have a significant bearing on asbestos-related liability claims, both in the short- and long-term.
In the more immediate future, the value of liability claims for mesothelioma may increase due to patients seeking private treatment. The new drug is currently at phase 3 of clinical trials, meaning that, conservatively, it may not be approved for NHS treatments for about three-to-five years. However, it could be available privately in the UK before this time.
It is worth considering the recent history of cancer immunotherapy. This was approved for UK usage a few years before it was made available through the NHS. Private treatments at this time cost approximately £12,000 per cycle, which would have been in addition to other related private healthcare costs, such as patient scans.
Plausibly, following the conclusion of the mesothelioma clinical trials, the new treatment could be available privately in the UK in the next 12 – 18 months. If private clinicians determine that patients are fit enough to receive this new treatment, claimants pursuing liability claims for cancer caused by asbestos exposure may look for settlements to fund private healthcare costs until provisions can be made via the NHS.
Looking further ahead, insurers may also have to reconsider the value of reserves for mesothelioma liability claims due to longer survival rates among patients. Results from the clinical trials have been published in the journal JAMA Oncology and show that the new cancer drug, combined with chemotherapy, quadrupled 3-year survival rates.
Reports in The Guardian highlighted one patient from the ADI-PEG20 (pegargiminase) trials, who had been given four months to live. He had won compensation from a former employer after being exposed to asbestos whilst working in a factory during the 1970s. Treatment during the clinical trials means that the patient is still alive five years after his diagnosis.
The case of this particular patient may well be an exception, and longer survival rates for mesothelioma sufferers could be more akin to the initial findings of the trials. However, provisions for increased life expectancy of patients will have a bearing on related liability settlements.
From experience, I’ve seen compensation sought for such cases vary between £100,000 to claims for over £1 million. These have considered circumstances including loss of earnings, care provision, the effect on life expectancy and the impact on dependents. Damages are usually awarded in the context of a relatively short survival period for patients, which could become less of a norm if the new treatment enables better control of this type of cancer.
The ADI-PEG20 (pegargiminase) trails have shown impressive results and mark a wonderful and much-welcome innovation for addressing an aggressive type of cancer. The breakthrough is a significant step forward for patients and could change their treatment and requirements. Liability claims will have to make new allowances to meet the needs of patients.
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