Immunotherapy is one of the many new clinical trials being used alongside surgery and chemotherapy to treat patients with mesothelioma. Immunotherapy works by boosting the patient’ immune system, allowing them to better defend against mesothelioma cells.
What Is Immunotherapy?
Immunotherapy is a mesothelioma treatment that uses the immune system enhancements to treat cancer. Typically, standard treatment options like radiation therapy pass through the immune system, attacking both cancerous and healthy cells. When healthy cells get destroyed during treatment, it makes recovery or prolonged life less feasible. That’s why doctors have been focusing on developing treatments like immunotherapy that preserve healthy cells.
Cancer immunotherapy has become an important part of cancer treatments within the past few decades. Immunotherapy works better for some cancers over others. While it is helpful in treating mesothelioma, it does not cure the disease. Immunotherapy is constantly being evaluated so that doctors can further learn of better ways to treat patients. It’s typically used in combination with standard mesothelioma treatments, including as a supportive therapy for patients who undergo surgeries.
How Does Immunotherapy Work?
To understand how immunotherapy works, it is important to look at how the immune system functions. The purpose of the immune system is to fight against infections and diseases. The immune system is made up of organs, cells, and various other substances. When cancer enters the body, the immune system detects this abnormal substance and attacks it.
However, cancer cells are harder to eliminate. Cancer is when the genes in a cell alter and grow uncontrollably. Because of its rapid and expansive rate, the immune system has a harder time fighting off the cancer cells—if it even detects it as a foreign substance to begin with. Some cancers don’t initially show up as a foreign object, or the immune system may be too weak to fight it off. Further still, cancer cells can even give off substances which trick the immune system into thinking the cell is healthy.
Immunotherapy works by enhancing the patient’s immune system so it can either fight off existing mesothelioma cells or prevent mesothelioma cells from growing and diving. When you undergo immunotherapy, doctors give you certain immunotherapy drugs, which trigger an immune system response, helping your body to better fight off mesothelioma.
Active and Passive Immunotherapy
There are two types of immunotherapies to consider: active and passive. The immune system itself works both actively and passively so it is important to explore their differences when discussing immunotherapy for mesothelioma.
A passive immune system is when your body reacts to cancer cells in your body. This is an instinct reaction based on your immune system’s predetermined knowledge of what is harmful to the body. Your immune system is born with these instincts.
Passive immunotherapy uses practices such as monoclonal antibodies to target specific harmful cells, or Cytokines to prevent further mesothelioma cells from developing. The passive immunotherapy works with the immune system to help stop the mesothelioma cells from spreading further into the body.
An active immune system is when your body learns which cells are harmful. Your immune system develops throughout your life and learns to recognize viruses, bacteria, and other pathogens such as cancerous cells.
Active immunotherapy uses practices such as immune checkpoint inhibitors to fight mesothelioma. These checkpoint inhibitors stop cancerous cells from hiding from your immune system. Some notable checkpoint inhibitors include Keytruda, Opdivo and Yervoy. Cancer vaccines are also sources of active immunotherapy. In addition to chemotherapy, these vaccines help control tumor growth longer than chemotherapy alone.
Benefits of Immunotherapy for Mesothelioma
Immunotherapy has been a monumental breakthrough in treatments for mesothelioma. Dr. Gerard Zalcman presented a study (titled MAPS2) testing the effects of immunotherapy in mesothelioma patients in 2017. The results showed an impressive outcome, with a one-year survival rate at 51% when patients took the immunotherapy medication nivolumab (Opdivo) and 58% when patients took both nivolumab and ipilimumab.
Dr. Zalcman spoke of his hopes for this new treatment in an interview with OncLive (2), indicating the possibility of using the drug over chemotherapy in the future.
“The positivity of this MAPS2 trial supports the use of immunotherapy as second- and third-line therapy.”
Another benefit of immunotherapy for mesothelioma is that it specifically targets pathogens, leaving minimal impact on healthy tissues.
Some additional benefits to immunotherapy include:
- Helps keep mesothelioma under control in conjunction with surgery and other first-line therapies
- Activates a response to the immune system to help fight off mesothelioma cells naturally
- Has fewer side effects than other first-line therapies such as chemotherapy and radiation, which helps to increase the survival rate
Current and Ongoing Research into Immunotherapy
The MAPS2 trial is the most current research into immunotherapy with the most promising results. Held in France, the clinical study considering 125 patients resulted in impressive results, including a slow growth of pleural mesothelioma after relapse. After 12 weeks of using the prescribed immunotherapy treatment, 44% of patients who received Opdivo did not experience mesothelioma growth. Further still, the cancer did not worsen for 50% of patients who received a combination of Opdivo and Yervoy.
Dr. Arnaud Scherpereel, head of the Pulmonary and Thoracic Oncology Department at the University Hospital (CHU) of Lille in Lille, France helped lead the MAPS2 study and concluded, “Our findings suggest that immunotherapy may provide new hope to patients with relapsed mesothelioma.”
The research into immunotherapy for mesothelioma concludes that any treatment therapy that specifically targets antigens in cancer cells is beneficial to the patient in preserving healthy pleura cells. Immunotherapy does that with the additional benefit of creating passive immunotherapies such as Cytokines to generate memory within the immune system, leading to long-term remission.
Immunotherapy Side Effects
Experimental treatments for mesothelioma that are still in their clinical trials have known to have side effects, though most negate long-lasting or damaging effects. Immunotherapy has been tried throughout various clinical trials, with minimal side effects. The side effects of immunotherapy vary from patient to patient and depend on the type of immunotherapy treatment given.
According to the National Cancer Institute, some side effects to immunotherapy include:
- A risk of skin infection such as itching, pain, burning or other symptoms near the injection area
- Weight gain from fluid retention
- Symptoms such as fever, chills, nausea, and other flu-related symptoms, including sinus congestion
- Trouble breathing, heart palpitation or changes in blood pressure
- Fatigue, dizziness or muscle aches
Undergoing Immunotherapy and Other Mesothelioma Treatments
Immunotherapy treatment is one of many that has the potential to change the lives of those living with mesothelioma. With its ability to target mesothelioma cells and it’s proven beneficial addition to first-line therapies, it is one of the most prominent treatments in expanding research for mesothelioma.
Clinical trials are currently accepting patients diagnosed with mesothelioma to test out new immunotherapy approaches. For more information about undergoing immunotherapy or other mesothelioma treatment, contact our Patient Advocates today.