New Mesothelioma Treatment Options Are Emerging for Patients
April 2, 2015
Although no definitive cure is in sight, the treatment of malignant pleural mesothelioma has entered a promising, much-anticipated phase that goes beyond the multimodal approach that has been the standard of care at specialty centers for the past several years.
There is new hope on the horizon.
Thoracic surgeon and renowned mesothelioma specialist Dr. Robert Cameron, along with scientist Raymond Wong, Ph.D., and cardiothoracic surgeon Dr. Svetlana Kotova, recently detailed the changing face of therapy in a paper they co-authored and published in the Cancer Management Research Journal .
“With all the ongoing research, real progress is only a matter of time,” they wrote. “The list of potential new therapies is long, and the number of clinical trials is impressive.”
Cameron, director of thoracic surgery at the Ronald Reagan UCLA Medical Center and medical advisor for the Pacific Meso Center in Los Angeles, has been a pioneer in the standard, three-pronged combination that includes lung-sparing surgery, chemotherapy and radiation.
Advances Making Mesothelioma Manageable
Cameron also believes future therapeutic advances are within reach, turning mesothelioma into a more manageable disease like diabetes.
Those advances include systemic therapies that affect the entire body in hopes of killing the cancer and localized treatments that specifically target the tumors. Many advances are part of on-going clinical trials showing promising results.
A majority of the newest therapeutic options stem from the improved understanding of the specific cancer biology and expanded knowledge of molecular signaling and immune responses. Research is paying off.
“Part of the reason for writing [this paper] was to create awareness,” Wong told Asbestos.com. “Not every clinical trial out there is the best option for a patient. But at least patients should now look into what is out there beyond conventional treatment.”
Systemic and Localized Therapies
Some of the newest potential drugs and therapies currently tested include immunotherapies that boost a patient’s immune system and drugs that slow the growth of new blood vessels to tumors, among others.
- Anti-mesothelin antibodies:Mesothelin is a protein overexpressed in several cancers, including mesothelioma, ovarian and pancreatic cancers. Antibodies MORAb-009 (amatuximab) and BAY 94-9343 (anetuman ravtansine) show an ability to kill cancer cells that overexpress mesothelin without harming normal cells.
- CRS-27 Vaccine:This vaccine also targets mesothelin but is designed to strengthen a patient’s immune system, allowing healthy cells to fight off cancer growth. It is a genetically altered bacteria engineered to induce an immune response within certain tumor types, allowing chemotherapy to be more effective.
- Avastin:Also known as bevacizumab, has been used for a decade to treat advanced renal cell, gastrointestinal stromal, and colorectal cancers. It involves slowing the growth of new blood vessels to tumors that lead to rapid cancer growth. It has been used effectively for mesothelioma in recent years when combined with chemotherapy.
- Dendritic Cell Vaccine:Another form of immunotherapy, but this one involves extracting specific white blood cells and cultivating them in the laboratory, where they are stimulated by a patient’s own antigens. They are reintroduced to the patient with a better chance of destroying the cancerous cells.
- Gene Therapy:Scientists are just learning how to attack mesothelioma at the molecular level by identifying genetic abnormalities and correcting or replacing them. It eventually could eliminate the need for surgery, radiation or chemotherapy.
- Cryotherapy:Used for many years with other cancers, cryotherapy involves the freezing of cancer tissue. It has been shown to be effective for mesothelioma when combined with certain types of immunotherapy.
- Photodynamic Therapy:Although first explored almost 30 years ago, this therapy has been reworked recently with new light-sensitive drugs allowing narrowly-targeting light beams to kill specific cancer cells.
- Iodine-Povidone Wash:Another older therapy gaining traction now with mesothelioma specialists involves the irrigation of cancerous areas following surgery to slow the regrowth of any tumor cells.
There currently are more than 200 clinical trials, ranging from phase I to phase III, involving mesothelioma nationwide. Many of them are designed to test new drugs and new therapies.
Finding Treatment Through Clinical Trials
The authors stressed the importance of clinical trial participation for a patient’s immediate benefit and for the benefit of future patients who will be helped by the research. Mesothelioma is a rare cancer with an estimated 3,000 patients diagnosed annually in the U.S.
“In the future, it is critical that clinicians treat this disease with equipoise, and that patients be placed in randomized prospective clinical trials in order to truly determine optimal therapy for these patients,” the authors wrote.