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Mesothelioma Emerging Treatments and Research

Mesothelioma is an aggressive type of cancer that attacks the layers of tissue surrounding organs in the body. This tissue is called the mesothelium, and cancer can affect it in various parts of the body. Most commonly mesothelioma develops in the tissue lining the lungs, called the pleura. Pleural mesothelioma is aggressive, typically not diagnosed until the later stages, and challenging to treat.

Traditional cancer treatments, such as combinations of surgery, chemotherapy, and radiation therapy, may be effective at extending the life of a mesothelioma patient and reducing pain, but they are rarely curative. The latest mesothelioma emerging treatments are finding new ways to target this terrible disease in the hopes of extending life expectancy and even curing this kind of cancer.

The Challenge of Treating Mesothelioma

Treatment is an ongoing challenge for patients with mesothelioma and for the specialists that care for them. One of the biggest challenges is that it is often diagnosed in later stages. This is because symptoms take years to develop, and when they do they mimic more common illnesses, including lung cancer in the case of pleural mesothelioma.

Another challenge is the speed at which mesothelioma spreads in the body as compared to other types of cancer. This means that even when caught in an early stage, stopping the spread of the cancer and curing it is difficult. With other cancers, surgery in the early stages has the potential to remove all cancerous tissue and cure it, but this is rarely the case with mesothelioma. Even when combined with chemotherapy and radiation, other standard cancer therapies, surgery often only prolongs a patient's life by months or a couple of years. Because mesothelioma is so difficult to treat with traditional methods, researchers are on the hunt for newer, better treatment strategies.

More Targeted Drugs for Mesothelioma

Chemotherapy is a standard treatment for many types of cancer. It involves using drugs to target fast-growing cells in the body. Cancer cells grow and divide rapidly, so these drugs accumulate in tumors and poison the cells. They generally target all cells in the body that grow quickly, though, so fast-growing healthy cells are harmed too. This means that chemotherapy may be effective as a cancer treatment, but it causes a lot of side effects. This can be very uncomfortable and damaging, even severe in some cases.

Ideally a drug used to kill cancer cells would be more targeted, and this is what some researchers are working on developing. Sunitinib is one of these newer, targeted drugs currently under study. 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 it will not harm healthy cells.

Photodynamic Therapy

Photodynamic therapy, or PDT, is a treatment strategy that more specifically targets cancer cells by using drugs activated by light. The drug is injected into the body and accumulates in the tumor. Once there a light is inserted into the chest cavity to activate the drugs. The light is directed at the tumor, so that other areas where the drug may have accumulated remain protected.

When activated, these special drugs go to work killing cancer cells. Because this is a targeted treatment, it could kill cancer cells and shrink mesothelioma tumors with minimal harm to healthy cells in the body. There are clinical trials ongoing right now testing PDT.

Immunotherapy

Targeting the immune system in a patient's body is another line of research in mesothelioma and cancer treatment. It works by using the immune system to target cancer cells. The immune system attacks pathogens like viruses and bacteria, but it can be stimulated to attack cancer cells too. The idea is essentially to use a cancer vaccine. An injected drug attaches to cancer cells so the immune system cells recognize them as pathogens.

Other immunotherapy emerging treatments vary in the approach. For instance, in one type of treatment, immune system cells are removed from the patient, manipulated in the lab to target cancer cells, and then put back in the body via blood transfusions. Other strategies use drugs to stimulate the immune system, which triggers it to go on the attack against abnormal cells, like cancer cells.

Gene Therapy

As a general medical approach 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.

Another approach is to use modified viruses. The viruses are manipulated so that they carry certain desirable genes. Injected into the body near the tumor, the virus targets mesothelioma cells and inserts those new genes. They make the cancer cells recognizable to the immune system as pathogens.

Virus Therapy

Research is also ongoing with viruses that do not use gene therapy. In this approach the idea is to design a virus that specifically attacks and weakens or kills 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.

Other Emerging Research

There are many other types of emerging treatments ongoing in cancer and mesothelioma research. Some aim to improve current methods of treatment. For example, radiation with intensity that can be modulated is showing promise as a more targeted treatment, while using radiation therapy to prevent the spread of mesothelioma is also under investigation. Another new line of investigation is using cryotherapy, or freezing cancer tissues, and has shown some effectiveness in treating mesothelioma.

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 exactly how this type of cancer is caused by asbestos and how it could be prevented. This kind of research is important because it broadens the overall understanding of the disease. This may prevent future cases of mesothelioma but can also contribute to the development of new, more effective treatments.

Also important is finding better ways to diagnose mesothelioma so that it can be caught, treated, and even cured in early stages. One line of diagnostic research is investigating the presence of biomarkers, molecules in the blood that could diagnose mesothelioma earlier and more accurately. If mesothelioma could be diagnosed earlier, all treatments would be more effective and more people could be cured of the cancer rather than given a death sentence.

The ongoing research into treating, and diagnosing, mesothelioma is crucial to helping to save more people from this terrible disease. Medical research like this is not always well funded, especially for rarer illnesses like this one. Education, awareness, and fundraising are crucial for helping this kind of research get more funding so that more people can be saved.

Page Medically Reviewed and Edited by
Luis Argote-Greene, MD

Luis Marcelo Argote-Greene, MD
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.
Sources
  1. American Cancer Society. (2018, November 16). What's New in Malignant Mesothelioma Research?
    Retrieved from: https://www.cancer.org/cancer/malignant-mesothelioma/about/new-research.html
  2. Kelly, R.J., Sharon, E., Pastan, I. & Hassan, R. (2012). Mesothelin Targeted Agents in Clinical trials and in Preclinical Development. Mol. Cancer Ther., 11(3), 517-25.
    Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3297681/

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