An analysis in the journal Critical Reviews in Oncology/Hematology examines different outcomes between patients with non-small cell lung cancer and mesothelioma, with a particular focus on the use of immunotherapy and surgery in both diseases. The authors note that tumor microenvironment, cellular mutations, histological subtypes, and predictive biomarkers all play a role, and stress the need for standardized pathological endpoints, better patient selection criteria, and larger randomized studies to optimize the sequencing and combination of immunotherapy, chemotherapy, and surgery in pleural mesothelioma.
Significant Differences Between Mesothelioma and Lung Cancer
Researchers from the Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy, undertook a comprehensive analysis of the differences between outcomes for mesothelioma patients treated with immunotherapy, surgery, and chemotherapy and those achieved for patients with non-small cell lung cancer. Where they have found significant success in the latter group, mesothelioma presents unique challenges that make treatment more complicated.
The researchers identified the biggest challenge in treating mesothelioma as the fact that the rare form of cancer grows so differently from lung cancer. While surgeons can often completely remove lung tumors, mesothelioma spreads along the mesothelial lining in an irregular, sheet-like pattern. This makes it nearly impossible for every cancer cell to be removed, leaving the likelihood of recurrence high.
Immunotherapy May Yield Better Mesothelioma Responses
While traditional chemotherapy before surgery only achieved complete responses in about 5-7% of mesothelioma patients, the researchers found that treatments combining chemotherapy with immunotherapy produced much better results, with up to 26% of patients achieving major responses. But not all mesothelioma patients respond the same way to immunotherapy. The type of mesothelioma makes a significant difference, with patients with sarcomatoid and biphasic types responding better to immunotherapy than those with epithelioid type. In one major study, patients with non-epithelioid types had much better outcomes with immunotherapy.
Another significant challenge is that many mesothelioma patients aren’t able to complete the full treatment. Studies have shown that only about half finish their entire plan due to side effects, cancer progression, or other health issues. Clinical trials are currently testing different combinations of therapies and new types of treatments, including “smart drugs” that can deliver chemotherapy directly to cancer cells while avoiding healthy tissue, and hope that this will provide better outcomes with fewer side effects.
If you or someone you love has been diagnosed with mesothelioma, the Patient Advocates at Mesothelioma.net are here to help. Contact us today at 1-800-692-8608 to learn more.
