When it comes to the extremely deadly cancer mesothelioma, discovering little rays of hope is crucial for patients who all too often feel truly helpless. While many researchers have been looking toward immunotherapy as the new ideal means through which to best treat cases of mesothelioma, specialized immunotherapy drugs have not worked for everyone.

Doctors still do not know why only certain people respond to immunotherapy drugs. When these drugs work as designed, they can ignite the full power of a patient’s immune system, causing it to attack and kill off cancer cells organically, from within.

Treating mesothelioma through other means, a rare cancer caused exclusively by asbestos, can be especially difficult because the cancer often develops and spreads slowly, over a long period of time (often 20-50 years)–and when the cancer is finally discovered, it is in many cases, unfortunately, too late.

Still, when mesothelioma is discovered, immunotherapy, along with highly invasive surgery, are 2 of the best lines of defense against the growth and spread of the disease. To solve the question of whether or not a given mesothelioma patient will respond to immunotherapy, researchers at the Mayo Clinic Center for Individualized Medicine have been studying large chromosomal arrangements that could offer doctors and surgeons clues.

Mesothelioma Response to Immunotherapy

Recently published in the Journal of Thoracic Oncology, Mayo Clinic researchers have discovered that the presence of particular large chromosomal rearrangements in mesothelioma cancer cells could serve as a predictive sign of a mesothelioma patient’s response to immunotherapy drugs. Lead author of the study and oncology researcher, Aaron Mansfield, M.D., said,

“What we’ve shown so far is that these large complex chromosomal rearrangements are frequent in mesothelioma and may provide a source of neoantigens (cancer proteins) that the immune system can recognize. It would be an entirely new way of predicting response.”

If doctors can predict the response a mesothelioma patient will have to immunotherapy, they will then have better insight as to the best course of action to take in order to maximize chances of a favorable outcome.

What Could This Study Mean for Mesothelioma?

The findings by Dr. Mansfield and his team are significant. Mesothelioma is an extremely difficult cancer to treat–its prognosis is often less than 12 months–and rarely do treatments lead to favorable results.

In many cases, the treating of mesothelioma is palliative–designed to lessen the pain a patient may be experiencing as a result of their disease. Because mesothelioma is most commonly found in older, retired men–skilled tradesmen and U.S. veterans who were exposed to asbestos regularly as part of their working careers–their late-life health impedes them from undergoing some of the more invasive surgeries that could remove the affected pleural linings from their lungs, abdomen, or heart.

Chemotherapy and radiation are 2 other well-known methods of treating cancer, including mesothelioma, but these often do not work for late-stage mesothelioma patients. Using an inexpensive technique called “mate pair sequencing,” Dr. Mansfield’s team was able to scan tumor cells for chromosomal abnormalities that can spur the growth of proteins. He explains,

“Mesothelioma does not have many of the mutations that are common in other cancers. Instead, there were chromosomal rearrangements that may have prognostic and therapeutic implications. We were able to identify complex patterns of rearrangements called chromothripsis and chromoplexy. The extent of these patterns has never before been described in mesothelioma.”

Finding these patterns could be a very important first step toward better treatment for all mesothelioma patients. If their research is verified through additional testing, Dr. Mansfield and his team at the Mayo Clinic believe their discovery could lead to a predictive method that identifies which mesothelioma patients will benefit from immunotherapy drugs.

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  1. https://newsnetwork.mayoclinic.org/discussion/science-saturday-discovery-advances-potential-individualized-treatment-for-mesothelioma/
  2. https://individualizedmedicineblog.mayoclinic.org/2018/11/26/mayo-clinic-discovery-advances-potential-individualized-treatment-for-mesothelioma/?_ga=2.946037.574403996.1545081790-1570390046.1543944633

Last modified: January 4, 2019