Epigenetic Therapy for Mesothelioma

Quick Summary

Despite our increasing knowledge surrounding mesothelioma, the patient prognosis has remained unfavorable. Research is starting to focus on genetic manipulations through epigenetic therapy, an emerging personalized treatment option which aims to reprogram mesothelioma cells back to their once healthy state.

Epigenetic Therapy Explained

If DNA provides the code to guide all cell functions and behaviors within the human body, then epigenetic modulation is a hereditary process that guides how this DNA is packaged. How DNA is packaged determines which genes are switched on and off, meaning which proteins are produced and which are not.

Over the past decade, our understanding of epigenetic regulation in both normal and cancer cells has dramatically increased. Studies have shown that epigenetic factors regulate the start and ongoing growth of cancer. This research is being used to develop drugs that reverse cancerous epigenetic changes with promising results found in treating mesothelioma.

Reversing Caner Cell Mutations

Unlike DNA abnormalities, epigenetic changes can be reversed and manipulated. When looking at the potential of this manipulation within cancer treatment, this means that epigenetic therapy can turn cancer cells back to healthy cells.

Epigenetic Therapy for Mesothelioma

All cancerous cells were once healthy, well-functioning and obedient pieces of the human body. Epigenetic therapy aims to reprogram cancer cells to return them back to their original state.

Although initially considered false, research has shown that epigenetic alternators are common events in the development of mesothelioma. This research provided the rationale for further investigation into epigenetic therapy for the treatment of mesothelioma.

Pleural mesothelioma is caused by exposure to airborne asbestos fibers that irritate the lungs, triggering mesothelioma cells to form within the lung lining (pleura). Standard treatments for pleural mesothelioma include chemotherapy, radiation and surgery, however, epigenetic therapy could offer a less invasive and more personalized and effective treatment alternative.

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Pleural Mesothelioma and Epigenetic Therapy

Pleural mesothelioma cells have very few mutations, meaning epigenetic alterations may be critical factors that determine how these cells mutate. Similar to other cancers, pleural mesothelioma also affects tumor suppressor genes—genes that protect cells from one step on the path cancerous mutation.

Certain types of epigenetic drugs have lacked success in treating pleural mesothelioma. However, that may be because these agents have been administered to maximum patient tolerance levels, resulting in toxicities. Recent studies into epigenetic therapy for pleural mesothelioma have shown that long-term exposure to epigenetic drugs is required to achieve positive results.

Benefits of Epigenetic Therapy

Epigenetic analysis and therapy is an important part of modern mesothelioma research and a large step towards personalized and minimally invasive treatment for the disease.

Epigenetic therapy may bring benefits for mesothelioma patients, including increased survival rates, reversal of resistance to conventional forms of mesothelioma treatment and reduced risks of recurrence when combined with conventional forms of treatment. Studies have shown that epigenetic therapy not only presents an initial response to cancer cells but provides long-term resistance as well.

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The Mesothelioma Help Guide is a FREE support resource for patients and families to help them better understand which treatment options will improve prognosis.

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Latest Research in Epigenetic Therapy

Given the relatively new use of epigenetic therapy for mesothelioma treatment, epigenetic drugs are only being administered through clinical trials and are not yet approved for use for the general public.

Because of how many epigenetic drugs (such as (5-AZA and DAC) work on cancer cells when administered intravenously or taken orally, they’re not always effective in patients with solid mesothelioma tumors. However, recent animal studies have found that these epigenetic drugs could be taken with other drugs to increase their effectiveness.

Researchers believe that the generally low survival rate of mesothelioma patients may be because many patients build a resistance to chemotherapy. The decrease in response to chemotherapy drugs is due to epigenetic errors which lead to poor gene expression in tumor cells.

Epigenetic Therapy as a Chemotherapy Support Treatment

Studies have found that epigenetic therapy may target gene expression errors and increases the effectiveness of chemotherapy treatments. In other words, epigenetic therapy can reduce cancer cell resistance to chemotherapy.

Preclinical data and clinical trials suggest that epigenetic therapy may also improve the efficacy of immunotherapy—a type of treatment that uses the immune system to kill cancerous cells—and that epigenetic therapy may increase patient survival rates depending on mesothelioma location and stage. Epigenetic therapy also has the potential to slow mesothelioma progression by periods of 2 or more years.

Future studies may allow researchers to gain a better understanding of how epigenetic and conventional mesothelioma treatments work together to bring further benefits to patients.

Undergoing Epigenetic Therapy for Mesothelioma

Given its rarity and complexity, mesothelioma can be a challenging disease to treat and manage. This does not mean that mesothelioma patients are without hope. Mesothelioma specialists and researchers are committed to developing new and effective treatments for the disease.

New approaches such as epigenetic therapy are essential to one day finding a cure, even if the treatment itself hasn’t yet shown tremendous results for mesothelioma.

If you are interested in learning more about epigenetic therapy and other new treatments available through clinical trials, contact our Patient Advocates today. Call us at (800) 584-4151 or receive a FREE Mesothelioma Help Guide to better understand available treatment options.

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Sources
  1. Annual Review of Medicine, “Epigenetic Therapeutics: A New Weapon in the War Against Cancer.” Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4937439/. Accessed on September 13, 2018
  2. Lung Cancer, “The role of epigenetics in malignant pleural mesothelioma.” Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/23790315. Accessed on September 13, 2018.
  3. Translational Lung Cancer Research, “Targeting the epigenome in malignant pleural mesothelioma.” Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5504118/. Accessed on September 13, 2018.
  4. ClinicalTrails.gov, “Study of the EZH2 Inhibitor Tazemetostat in Malignant Mesothelioma.” Retrieved from: https://clinicaltrials.gov/ct2/show/NCT02664181. Accessed on September 13, 2018.
  5. ClinicalTrails.gov, “Mithramycin for Lung, Esophagus, and Other Chest Cancers.” Retrieved from: https://clinicaltrials.gov/ct2/show/NCT01624090. Accessed on September 13, 2018

Last modified: December 31, 2018