Mesothelioma, the rare and fatal form of cancer caused by exposure to asbestos, presents unique treatment challenges. A newly published analysis notes that most genetic mutations found in mesothelioma involve tumor suppressor genes rather than the driving mutations seen in other cancers, making it difficult to develop targeted therapies. Still, there is hope for success with innovative new treatments.
Current Mesothelioma Treatment Options Show Limited Success
In a just-published review, Libo Zhang and Meijuan Huang of the Division of Thoracic Tumor Multimodality Treatment and Department of Medical Oncology at the Cancer Center of West China Hospital and Sichuan University, China, note that current mesothelioma treatments rely on a combination of surgery, chemotherapy, and newer immunotherapy approaches, but deliver only modest results.
Included in these therapies are mesothelioma surgery, with pleurectomy/decortication generally preferred over more extensive procedures due to lower mortality rates; chemotherapy using platinum-based drugs combined with pemetrexed; bevacizumab, an anti-angiogenic drug; and immunotherapy combinations like nivolumab plus ipilimumab, which have shown some promise. Still, overall survival has been limited.
How Mesothelioma Evades the Immune System
According to the researchers, mesothelioma creates what they call an “immune-cold” environment. This means that the body’s natural defenses struggle to recognize and attack the cancer’s cells. Instead, the tumor is primarily infiltrated by cells that suppress immune responses rather than those that fight cancer.
In mesothelioma, tumor-associated macrophages and myeloid-derived suppressor cells actively prevent T-cells and other immune warriors from doing their job. This hostile immune environment explains why immunotherapy, while showing some success, hasn’t been as effective against the aggressive cancer as scientists and physicians had anticipated.
Emerging Mesothelioma Therapies Offer New Hope
Despite previous disappointments, the mesothelioma researchers point to several promising new approaches being investigated. Scientists are investigating epigenetic therapies that can “reprogram” cancer cells by modifying how genes are expressed without changing the DNA itself. CAR T-cell therapy, which engineers a patient’s immune cells to better recognize cancer, shows early promise, especially when targeting a protein called mesothelin that’s highly prevalent in mesothelioma cells. Researchers are also developing dendritic cell vaccines and exploring combination treatments that attack the cancer from multiple angles simultaneously.
Most promising of all, mesothelioma treatments are moving toward personalized medicine approaches that match therapies to individual tumor characteristics. Advanced technologies like single-cell analysis and artificial intelligence are helping researchers identify new targets and predict which treatments will work best for specific patients. While current treatments offer only modest survival benefits, these innovative approaches provide hope that future therapies will achieve the goal of transforming this aggressive cancer into a manageable chronic disease.
If you or someone you love has been diagnosed with mesothelioma, the Patient Advocates at Mesothelioma.net can help. Contact us today at 1-800-692-8608 to learn more.
