New Treatments for Mesothelioma

Quick Summary

For decades, scientists have been working to find a lasting cure for mesothelioma—a rare and deadly cancer that remains incurable as of now. In recent years, experts have developed promising new treatment approaches and therapies. These top emerging treatments range from gene therapy to SMART surgery.

What are New Mesothelioma Treatments?

The typical treatment for mesothelioma involves a combination of surgery, chemotherapy, and radiation. However, new clinical therapies take mesothelioma treatment to the next level by helping reduce pain and other symptoms associated with mesothelioma and its current treatment process. Some of the new mesothelioma therapies take unconventional approaches to standard multimodal treatments, redefining traditional mesothelioma treatment guidelines.

Scientists have developed at least five different types of advanced treatments for patients with mesothelioma:

  • Photodynamic therapy
  • Gene therapy
  • Immunotherapy
  • Virotherapy
  • SMART therapy

These new treatments are in their experimental stage, but because of the aggressiveness of current procedures, experts have worked to find therapeutic modalities to provide a more tolerable form of treatment. Many of these new experimental treatments have already shown great promise in the survival rates of mesothelioma patients. Doctors use these new treatments in conjunction, rather than in substitution, with current mesothelioma treatments such as surgery and chemotherapy.

Combining new treatments with traditional methods has helped in increasing the survival timeline for those living with mesothelioma. While these new mesothelioma treatments do not provide a cure for the disease, they have proven to be groundbreaking in research development for prolonging the lives of mesothelioma patients.

The survival rate for mesothelioma patients is currently at an estimate of 10-15 months after diagnosis. With these new treatments, patients have been experienced fewer relapses after traditional treatment and expose promising survival outcomes.

What are the Goals of New Mesothelioma Treatments?

New mesothelioma treatments have been in development over several decades to prolong the lives of those diagnosed with this type of cancer. At the current rate, mesothelioma patients can expect to prolong their life by up to a year, depending on cancer’s progression.

Mesothelioma has no known cure, but these new treatments are bringing experts closer to providing a maintainable lifestyle for patients by suppressing the growth of the malignant tumors. With new therapies, doctors aim to manage mesothelioma, much like how diabetes is normally monitored.

The goal of these treatments is to provide an alternative way to cope with the side effects of mesothelioma and as a way to branch from the standard care so that a cure or further sustainable treatment may be uncovered. Further exploration into these treatments enables doctors and experts to give options to their patients and increases the chances of finding a prolong survival rate.

Photodynamic Therapy

PDT is a light-based mesothelioma treatment. It uses photosensitizing agents along with specific light wavelengths to kill cancer cells.

Photodynamic Therapy (PDT) is an adjunct (additional) procedure that doctors may use for mesothelioma patients post-surgery. After removing the tumor, PDT acts as a stimulant by treating the lung surface after removing part of pleura (pleurectomy).

PDT increases surgical resection (tumor removal) so that patients can be treated with a pleurectomy instead of an extrapleural pneumonectomy—a more intense surgical operation that removes the lung as well as a portion of the diaphragm, the parietal pleura, and the pericardium.

Joseph Friedberg MD and co-director of the Penn Mesothelioma and Pleural Program emphasized that he was encouraged by the results of PDT.

“Based off our new findings, we are redoubling our clinical and translational research efforts to find a way to further improve and refine this multimodality treatment approach for mesothelioma.” — Dr. Joseph Friedberg

So far, PDT’s effects are superficial, but clinics have praised its success in supporting mesothelioma treatment. New research founded by the Perelman School of Medicine at the University of Pennsylvania showed an increase in survival rate to an average of 41.2 months with the assistant of photodynamic therapy.

Immunotherapy

Immunotherapy for mesothelioma patients has proven to be a promising, yet, challenging endeavor. It has been used to treat other cancer types by boosting the immune system so it can more effectively fight off pathogens.

After chemotherapy and radiation—key treatments for mesothelioma patients—the immune system decreases in function. With immunotherapy, doctors hope to preserve immune system function to help antibodies further fight off mesothelioma cells.

In a study entitled MAPS2, performed by lead study author, Gerard Zalcman, MD, patients who received immunotherapy alongside chemotherapy drugs saw an impressive increase in survival rates.

When trade drugs such as nivolumab where combined with immunotherapy, the one-year survival rate increased to 51%. An even higher rate of 58% showed when immunotherapy was used in combination with both nivolumab and ipilimumab.

Nivolumab and ipilimumab are immunotherapy drugs that, when combined together, use antibodies to attack cancer cells. In addition to attacking cancer cells, these drugs also help preserve the immune system’s healthy cells, resulting in a higher survival rate.

Gene Therapy

Gene therapy is a clinical experiment where new, modified genes infect mesothelioma cells. Lab technicians modify genes to turn them into a virus that is then injected in the patient’s pleural space (the lung where asbestos settles). Once injected, the new genes infect and attack the cancerous cells from within.

Gene therapy has also been speculated to be an ally to the immune system. When a damaging agent such as asbestos enters into the body, it amplifies the risk of the genes in the body’s cells to divide. These defective genes are what experts believe to be the leading cause of cancer. Gene therapy acts a modifier to fix those broken, cancerous cells. Instead of attacking both the healthy and defective (cancerous) cells, gene therapy avoids interaction with intact (healthy) cells, increasing survival due to a healthier immune system.

Researchers have been testing gene therapy in clinical trials for over two decades with various outcomes in treating mesothelioma. Some have proven to produce anti-tumor effects, alowing doctors to continue their investigation into this type of treatment. The FDA didn’t approve of gene therapy treatment for mesothelioma until 2017.

SMART—Surgery for Mesothelioma After Radiation

SMART (surgery for mesothelioma after radiation) combines radiation and surgery, but in a specific order, challenging standard treatment protocols.

The goal of SMART is to use radiation to reduce the spread of the tumors. Radiotherapy is used to treat the areas where small tissues were taken, or where fluid was drained. SMART is only used with extrapleural pneumonectomy—complete removal of the lung, the lining of the lung and heart, and some of the diaphragm. SMART cannot be used in conjunction with any type of surgery for treatment of mesothelioma.

One study by the University of Toronto showed that SMART more than doubled the survival rate from 32% to 72% in pleural mesothelioma patients who underwent this treatment approach.

Virotherapy

Like gene therapy, virotherapy uses genetically engineered viruses to attack cancer cells so that healthy cells can remain unscathed during treatment. The ability to specifically kill the cancerous cells (instead of healthy cells) increases chance for survival as it only attacks the malignant pathogens in the body. Experts also believe that its use combined with other source of treatments will increase its efficiency in targeting the pleural tumors associated with mesothelioma.

Virotherapy has been successful in other clinical trials for patients diagnosed with various types of cancers. A genetically modified Herpes simplex virus (HSV 1) became the first cancer virotherapy to be FDA-approved in 2015. Clinical studies for this type of treatment are currently scarce, and experts are looking to open more clinical trials for those with mesothelioma.

Accessing Clinical Trials

At this point, new treatments are only being tested through clinical trials. However, they are being tested not only in the United States, but around the globe. A clinical trial in France was a part of the research that uncovered immunotherapy success in slowing down relapse growth in patients with mesothelioma.

Ask your doctor about participating in clinical trials. It’s important to note that these new treatments for mesothelioma are in their trial periods and not approved by the FDA or insurance companies.

If you or a loved one has been diagnosed with mesothelioma, contact our Patient Advocates today. We can provide you with information on existing clinical trials currently recruiting patients with your exact mesothelioma diagnosis.

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Sources
  1. Cancer Research UK. “A trial looking at radiotherapy to prevent spread of mesothelioma after a chest wall procedure (SMART trial)”. Retrieved from: http://www.cancerresearchuk.org/about-cancer/find-a-clinical-trial/a-trial-looking-radiotherapy-prevent-spread-mesothelioma-after-chest-wall-operation-smart-trial#undefined. Accessed on 1/09/2018.
  2. Medscape. “Mesothelioma Treatment & Management”. Retrieved from: https://emedicine.medscape.com/article/280367-treatment. Accessed on: 1/10/2018.
  3. Frontiers in Oncology. “Oncolytic Viral Therapy for Mesothelioma”. Retrieved from: https://www.frontiersin.org/articles/10.3389/fonc.2017.00179/full. Accessed on 1/11/2018.
  4. NCBI. “Oncolytic virotherapy for human malignant mesothelioma: recent advances.” Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4918388/. Accessed on: 1/12/2018

Last modified: May 7, 2018