Though malignant mesothelioma remains one of the most challenging types of cancer, there are tremendous breakthroughs being made in research every day, and each one brings us closer to more effective treatments and an eventual cure. Among the most promising of these is inquiry into the tumor microenvironment or TME. This scientific term describes the area that surrounds the tumor. Researchers believe that weaknesses in these areas can be exploited to improve immune response.
Mesothelioma Tumors are Supported by Surrounding Cells
At the heart of this mesothelioma research is analysis of the stroma, which are cells that not only hold the tumor in place but which also enhance the tumors’ ability to grow and spread. In addition there are the various blood vessels that deliver nutrients and oxygen to the tumor, as well as immune cells that attack them. Understanding the way that these external structures work is the goal of the TME research being led at Cardiff University by Dr. Zsuszanna Tabi.
Dr. Tabi is particularly interested in determining whether the environments surrounding mesothelioma tumors are inflammatory or immunosuppressive. She explains that, “The biggest breakthrough in cancer treatment happened in the last decade or so with the success of melanoma treated with immune checkpoint inhibitors. About 20–30% of patients with advanced disease respond extremely well to this treatment, which “takes the brake off” the immune cells, with complete recoveries or long remissions often observed. But in the remaining 70–80% of patients the TME is either too “hostile” (i.e. immunosuppressive) to allow this immune treatment to work, or the right immune cells are simply not present. So, a major focus is to find out how the TME can be changed in order to enable the checkpoint inhibitors to work.”
Determining Whether Mesothelioma Tumors Are “Hot” or “Cold”
Dr. Tabi explains that some cancers are immunologically cold while others are hot. In cold tumors the immune system does not fight the cancer, while hot tumors see profound immune responses. In the latter, immunotherapy has been very effective. If researchers can determine whether mesothelioma tumors are hot or cold, they will have a better sense of how to use this treatment protocol.
“An inflammatory environment is advantageous while an immunosuppressive environment allows the tumor to progress,” she explained. “Mesothelioma is interesting because there are two types of mesothelioma: one is hot and the other is cold and there is nearly nothing in between. However, because there are not many immunotherapy trials in mesothelioma, we don’t really know the meaning of this yet. Then it gets even more complex because there are some multifocal tumors where each lump is different – so within one patient, one tumor could be immunologically cold and another hot. In this scenario, it has been observed that some of the lumps can be removed with successful immunotherapy but the others can’t.”
Research like that being conducted by Dr. Tabi will prove invaluable in the fight against mesothelioma. If you or someone you love has been diagnosed with this disease and you need more information, contact us today at 1-800-692-8608.
