Is Mesothelioma Curable?
Mesothelioma is not curable at any stage, but the prognosis for stage 1 or stage 2 is more favorable than later stages. Patients with peritoneal mesothelioma typically survive longer than pleural mesothelioma patients, but there is no definitive cure for any type of this cancer.
However, long-term remission or no evidence of disease can occur in some patients through cancer treatments such as surgery, chemotherapy and immunotherapy.
Breakthroughs in clinical trials are getting researchers closer to finding a cure for mesothelioma. Some survivors are living longer, healthier lives, despite the less-than-optimistic prognosis.
Mesothelioma Research to Find a Cure
Doctors and researchers are working on developing a mesothelioma cure by improving conventional treatments for mesothelioma.
As a result, surgeries are more precise, therapies are more exact, and chemotherapy and radiation are more effective.
Researchers are refining these treatments to find a mesothelioma cure:
- Chemotherapy: The most effective chemotherapy treatment combines the FDA-approved drugs pemetrexed and cisplatin. Researchers are now looking at the possibility of adding Avastin (bevacizumab) to the combination. The hope is that all three drugs will delay the cancer spread and increase overall survival rates.
- Surgery: Extrapleural pneumonectomy, pleurectomy and decortication and cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy, or HIPEC, are major mesothelioma surgeries. Researchers are evaluating if adding heated chemotherapy or cryotherapy (freezing of tumors) to certain surgical procedures will improve overall effectiveness.
- Radiation: Intensity-modulated radiation therapy, also known as IMRT, is becoming the preferred form of radiation for mesothelioma because it precisely targets tumors from multiple directions without harming healthy tissue.
- Tumor Treating Fields: Also known as TTFields, this new therapy uses alternating electrical fields to stop tumor growth and spreading. In 2019, it became the second therapy approved by the U.S. Food and Drug Administration to treat pleural mesothelioma.
- Multimodal: A multimodal therapy approach that combines surgery with chemotherapy and radiation has proven effective in early-stage patients. Even patients who are not candidates for surgery have found chemotherapy and immunotherapy combinations that can work for them.
Clinical trials across the nation also are recruiting patients in an effort to find a cure for mesothelioma.
Mesothelioma Research Centers
Some of the most important and impactful research is underway at mesothelioma research centers throughout the U.S.
Most of this research takes place at universities, cancer centers, research centers and hospitals.
Some of these centers and hospitals include:
- National Institutes of Health
- Shukla Research Lab at the University of Vermont
- Harvard Medical School’s partnership with the Brigham and Women’s Hospital
- Vaccine and Immunotherapy Center at Massachusetts General Hospital
This is not the death sentence it was 20 years ago. Long-term survival is possible. We now have the road map, and others have traveled the path. I remain optimistic that we can, in the next decade, put together the right combination of patient and treatment to affect a cure, which is our holy grail.Dr. David SugarbakerThoracic Surgeon
Emerging Treatments for Mesothelioma
Immunotherapy is considered one of the greatest medical advances for the mesothelioma community. It is sparking optimism with promising results in multiple clinical trials around the world. Researchers are focused on the potential benefits of using patients’ own immune systems to combat mesothelioma.
Immunotherapy is part of the broader field of targeted therapy, which uses drugs to target the cancer’s specific genes, proteins or the environment around the tumor that contributes to cancer growth.
Keytruda (pembrolizumab) is the drug responsible for saving former President Jimmy Carter from melanoma cancer in 2015. It is one of the most well-known immunotherapy drugs. Keytruda continues to show groundbreaking effectiveness in mesothelioma clinical trial participants.
Scientists continue to study the possibility of manipulating a patient’s genes to treat or prevent certain diseases. The goal of gene therapy is to directly repair problems caused by defective genes.
One type of gene therapy, known as suicide gene therapy, genetically modifies cancer cells to include a gene that kills the cell.
Another type of gene therapy targets the p53 gene, a gene that helps the immune system find and kill cancer cells.
It [the cure] is out there somewhere now. We just have to start thinking outside the box more. We’ve got to come up with something that no one has put together yet. But it’s there.Dr. Raja FloresThoracic surgeon
For pleural mesothelioma patients, gene therapy is feasible. Doctors can easily reach the pleural membrane to deliver genes, conduct biopsies and monitor treatment results.
While gene therapy does not currently offer a permanent cure for mesothelioma, it has shown promise in clinical trials.
Photodynamic therapy is an experimental therapy for mesothelioma that uses light to kill cancer cells.
The treatment involves giving patients a photosensitizing drug that makes cancer cells sensitive to light. The light is administered during surgery, allowing surgeons to directly target any remaining cancer cells left behind after surgery.
Clinical trials are testing photodynamic therapy in mesothelioma patients who qualify for surgery at Roswell Park Cancer Institute in Buffalo, New York, and Penn Medicine Abramson Cancer Center in Philadelphia.
Vaccine therapy, also known as virotherapy, uses viruses and viral immunotherapy to kill cancer cells. It uses principles of immunotherapy to get the body’s immune system to attack the cancer. Viruses used in this therapy are typically altered in a lab before being injected into the patient.
There is an ongoing clinical trial at Mayo Clinic in Rochester, Minnesota, evaluating the potential for an intrapleural injection of the measles virus to attack pleural mesothelioma.
French researchers published a study in 2016 on the survival improvement observed in pleural mesothelioma patients who were given bevacizumab, an anti-angiogenic drug that works by preventing the spread of mesothelioma.
The study reported an overall survival of 18.8 months among patients who received chemotherapy and bevacizumab. The control group received only chemotherapy and overall survival in the group was 14 months.
However, according to a 2018 review of current trends in mesothelioma treatment, other anti-angiogenic drugs have not proven successful in large, randomized clinical trials.
Breakthroughs in Clinical Trials Bring Us Closer to a Cure
Researchers are tirelessly looking for new therapies because traditional treatment options don’t work well for mesothelioma.
Currently, the process for introducing a new asbestos cancer medication typically takes 12 to 15 years. To ensure patient safety, adequate time must be spent in each stage of the development process. This is where clinical trials come in.
Preliminary research for clinical trials test new drugs on samples of mesothelioma tumors, rather than on patients directly, thanks to the National Mesothelioma Virtual Bank.
It takes nearly seven years for a new medication to make it to the first phase of a clinical trial. From there, the medication goes through four phases of clinical testing before becoming available for all patients.
Clinical trials help researchers improve their understanding of mesothelioma and find new ways to combat the disease. Once a specific drug or treatment has shown some success and safety in a lab setting, it can be studied in a clinical trial.
Recent clinical trials have greatly improved our ability to treat mesothelioma. One new therapy under investigation is photodynamic therapy, which uses light to kill cancer cells. Another new therapy is epigenetic therapy, which reverses the genetic damage that contributes to cancer development.
Obstacles to a Cure for Mesothelioma
Thanks to researchers, the future is looking much brighter for people diagnosed with mesothelioma. But there are still several hurdles we must cross on the road to a cure.
Mesothelioma is a rare form of cancer. Unlike the more common lung, colon and breast cancers, there is a distinct lack of awareness and research dollars. Federal funding for government research on mesothelioma is significantly less compared to other cancers.
The biggest problem with the lack of mesothelioma awareness is that doctors don’t get a chance to treat many patients in an early stage of the cancer. The insidious nature of the disease is that symptoms may not be painful or even noticeable to the patient during early stages. Symptoms often mirror those of less serious health issues, slowing the diagnosis while the disease is spreading.
If a patient is not diagnosed until stage 3 or 4 of cancer development, treatment options are much more limited. This may disqualify patients from certain treatments, such as surgery, and it can make it harder for patients to participate in clinical trials.
“The real gains will be made from finding it earlier,” said Harvey Pass, M.D., a surgeon and long-time leader in mesothelioma advancements. “Treatments will work better. It could be very important in turning this into a chronic illness.”
Researchers are working on developing approaches to treatment that may be able to downstage a patient’s cancer in order to qualify for surgery, which offers the best chance at long-term survival.
For example, a 2020 report published in General Thoracic and Cardiovascular Surgery described a stage 3 patient who responded well to chemotherapy and was downstaged to stage 2. The patient then underwent aggressive surgery and was alive at 30-month follow-up while receiving another round of chemotherapy to fight a recurrence.
Closer to a Cure Than Before
Finding the absolute mesothelioma cure still may be years away, but finding a way to control mesothelioma has taken hold.
The six-months-to-live prognosis is no longer the norm at specialty centers with experience in treating this rare disease. Patients diagnosed early are living considerably longer today. It is no longer unusual to find a five- or ten-year mesothelioma survivor. There is hope.
Common Questions About Finding a Mesothelioma Cure
- Has anyone been cured of mesothelioma?
There is currently no cure for mesothelioma, although some patients have lived several years beyond the average life expectancy. Advancements in treatments through mesothelioma clinical trials continue to provide patients hope for an eventual cure.
- Are there any promising new mesothelioma treatments?
Researchers are exploring new mesothelioma treatment options with encouraging potential. Physicians are combining immunotherapies for mesothelioma with chemotherapy to improve survival. New targeted treatments such as gene therapy continue to enhance the efficacy of anti-cancer action while minimizing damage to healthy tissue.
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