New Mesothelioma Treatments and Research
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Medical researchers are working on emerging mesothelioma treatments to give patients better outcomes. Curing this aggressive cancer is still rare, but new treatments, like tumor treating fields and immunotherapy, may help extend life expectancy for many patients.
Why Is Mesothelioma So Difficult to Treat?
Traditional cancer treatments may effectively extend a mesothelioma patient’s life and reduce pain, but they are rarely curative.[1]
Pleural mesothelioma, which affects the tissue around the lungs, is the most common type.[2] It is aggressive compared to other cancers. Effective treatment is an ongoing challenge:
- One of the biggest challenges is that it is often diagnosed in later stages, when the cancer has spread.[3]
- Another challenge is that mesothelioma spreads rapidly. It is an aggressive cancer.
- Unlike many other cancers, mesothelioma does not grow as a single tumor. It spreads along surfaces and blood vessels. Surgery to remove all of the malignancies is not always possible.[4]
- Mesothelioma is rare, which means that doctors have few cases for comparison in order to determine the best treatment.[4]
Because of these challenges, the standard cancer treatments–chemotherapy, surgery, and radiation–are not always effective. Researchers are working on new treatments to help mesothelioma patients live longer and with a better quality of life.
Mesothelioma Research: Cause, Prevention, and Diagnosis
The research that directly tests new therapies and treatments is not the only important research ongoing with respect to mesothelioma. Researchers are also working on determining how asbestos causes mesothelioma and how it could be prevented.
Also important is finding better ways to diagnose mesothelioma so that treatment can begin in the earlier stages. One line of diagnostic research is investigating the presence of biomarkers, molecules in the blood that could diagnose mesothelioma earlier and more accurately.[5]
Targeted Drugs and Gene-Based Medications for Mesothelioma
Chemotherapy is a standard treatment for many types of cancer, including mesothelioma. The effects on mesothelioma are generally short-term, so researchers are testing new drugs that may be more effective.[6]
Sunitinib is one of these newer, targeted drugs currently under study.[7] Drugs that are specifically designed to target a protein called mesothelin are also under development and in clinical trial stages.
Mesothelin helps differentiate tumor cells from healthy cells so that drugs targeting them will not harm healthy cells.[8]
Another type of targeted therapy uses a patient’s genetic information to determine an effective medication. For instance, researchers are interested in the BAP1 genetic mutation. Targeting it with a specific drug may inhibit an enzyme that protects cancer cells.
Learn more about targeted therapies here.
Photodynamic Therapy
Photodynamic therapy, or PDT, is a treatment strategy that targets cancer cells by using light-activated drugs. The drug is injected into the body and accumulates in the tumor.
Doctors then insert a light into the chest cavity to activate the drugs. The light is directed at the tumor to protect other areas where the drug may have accumulated.[6]
When activated, these special drugs go to work, killing cancer cells. Because this is a targeted treatment, it kills cancer cells and shrinks mesothelioma tumors with minimal harm to healthy cells in the body. Clinical trials are ongoing right now.[6]
Learn more about photodynamic therapy here.
Immunotherapy
Targeting the immune system is another line of research in mesothelioma and cancer treatment. Treatments use the patient’s own immune system to target cancer cells. Some immunotherapy drugs come in vaccine form. An injected drug attaches to cancer cells, so the immune system cells recognize them as pathogens.[6]
In October 2020, the FDA approved the first immunotherapy treatment for pleural mesothelioma. The combination of Opdivo and Yervoy is still being tested in clinical trials.[9] Keytruda (pembrolizumab) is another immunotherapy drug that may help patients with mesothelioma.
Learn more about immunotherapy here.
Tumor Treating Fields
A new type of therapy was recently approved for treating mesothelioma patients when used along with chemotherapy. Known as tumor treating fields or TTFields, the system applies alternating electric fields to the cancerous tissue from outside the body. It is non-invasive and shows promising results in extending life expectancy.[10]
Learn more about TTFields here.
Advances in Multimodal Treatment
Currently, the most effective way to treat mesothelioma is with a multimodal approach. This means using more than one treatment, typically a combination of two or three of the standard cancer treatments: chemotherapy, surgery, and radiation therapy.
Not all mesothelioma treatment research is focused on new therapies or medications. Some target new and better combinations of treatments:
- Four-modality treatment. Using four treatment strategies is relatively new but showing promise for patient outcomes. In one study, patients received immunotherpay, surgery, chemotherapy, and radiation therapy. Most patients tolerated treatment and had improved survival times.[11]
- Chemotherapy-immunotherapy. Some researchers are investigating combinations of chemotherapy and immunotherapy in patients who do not qualify for surger. One study found that the combiation of standard chemotherapy with durvalumab improved survival times in these patients.[12]
- The SMART protocol. Researchers have been working on SMART (surery for mesothelioma after radiation therapy) in recent years, hoping to develop it as an effective multimodal treatment. The patient receives intensity-modulated radiation therapy to shrink the edges of tumors. A surgeon the has a better chance of removing all or most of the cancerous tissue. A recent large study found improved outcomes and longer survival times for patients undergoing the SMART protocol.[13]
Learn more about multimodal therapy here.
Other Emerging Treatments
Some other emerging treatments are newer and require more research and clinical trials but show promise for managing mesothelioma:
- Gene Therapy. Gene therapy involves manipulating the genes in the DNA of certain cells to treat or cure a disease. For mesothelioma, gene therapy as a treatment is being tested by inserting new genes into the cancer cells. These changes are expected to make the cells easier to kill with other treatment strategies.[6]
- Vaccine Therapy. Some researchers are also designing viruses that specifically attack and weaken or kill mesothelioma cancer cells, but not other types of cells. This kind of therapy is in the early stages of research and clinical trials, but there is hope that it could be an effective treatment in the future.[6]
- Radiation Therapy. Intensity-modulated radiation therapy also shows promise as a more targeted treatment, while using radiation therapy to prevent the spread of mesothelioma is also under investigation.[14]
- Cryotherapy. Another new line of investigation is using cryotherapy, or freezing cancer tissues, and has shown some effectiveness in treating mesothelioma.[15]
- Gold Nanotubes. Early research into an unusual new treatment shows promise for mesothelioma patients. Although not yet trialed in human patients, researchers found that mesothelioma cells readily absorb gold nanotubes the size of one-thousandth the width of a hair. These tubes absorb light, heat up, and kill the cells from the inside.[16]
Are Any New Mesothelioma Treatments Curative?
There is still no cure for mesothelioma, but researchers continue to get closer to managing this terminal illness. Improved treatments combined with better diagnostic procedures give patients more time than ever before.
How Can I Access New Mesothelioma Treatments?
Some of these newer treatments are available in select treatment facilities. You have a better chance of access if you receive care at a specialty cancer center with oncologists and surgeons experienced in treating mesothelioma patients.
Another way to access emerging and experimental treatments is through clinical trials. These studies investigate novel treatments for safety and efficacy using volunteer patients.
Talk to your medical team about how you can access any of these treatments that interest you. They can tell you if those treatments are available where you receive care. If the treatments are only accessible through clinical trials, they can help you find a trial and determine if you qualify to enroll.
The ongoing research into treating and diagnosing mesothelioma is crucial to help save more people from this terrible disease. Education, awareness, and fundraising are crucial for helping this kind of research get more funding to save more people.
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Luis Argote-Greene is an internationally recognized thoracic surgeon. He has trained and worked with some of the most prominently known thoracic surgeons in the United States and Mexico, including pioneering mesothelioma surgeon Dr. David Sugarbaker. He is professionally affiliated with University Hospitals (UH). His areas of interest and expertise are mesothelioma, mediastinal tumors, thoracic malignancies, lung cancer, lung transplantation, esophageal cancer, experimental surgery, and lung volume reduction. Dr. Argote-Greene has also done pioneering work with video-assisted thoracoscopic surgery (VATS), as well as robotic assisted minimally invasive surgery. He has taught the procedures to other surgeons both nationally and internationally.