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Targeted Therapy for Mesothelioma
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Targeted therapy for mesothelioma aims to kill cancer cells or block their growth. The U.S. FDA has approved two targeted therapies for mesothelioma including Yervoy (ipilimumab) and Opdivo (nivolumab), which help the immune system locate and kill mesothelioma cells.
Written by Sean Marchese, MS, RN | Edited By Walter Pacheco | Last Update: July 2, 2024
Written by Sean Marchese, MS, RN | Edited By Walter Pacheco | Last Update: July 2, 2024
What Is Targeted Therapy?
Targeted therapy is a cancer treatment designed to attack cancer cells while sparing normal cells. Different targeted therapies use specific methods to single out cancer cells or block mechanisms that promote cancer growth.
Also known as precision medicine or personalized medicine, targeted therapies use specific proteins, enzymes and other molecules involved in cancer cell maintenance or growth to kill or prevent cancer cells from growing and spreading.
In general, targeted therapies may have fewer side effects than other cancer therapies, such as chemotherapy. Two targeted therapy drugs approved to treat mesothelioma are Yervoy (ipilimumab) and Opdivo (nivolumab). Though they’re approved, they are still considered emerging treatments. Several other drugs are under investigation to treat mesothelioma.
Types of Targeted Therapy
Targeted therapies primarily fall into two types. These include monoclonal antibodies and small-molecule drugs.
Categories of Targeted Therapy
- Monoclonal Antibodies: This type of targeted therapy includes proteins made in laboratories that target compounds on the outside of cancer cells.
- Small-Molecule Drugs: These include a group of drugs small enough to enter cancer cells, which makes them useful for targets inside cancer cells.
Specific monoclonal antibodies help the immune system recognize cancer cells and attack them. Others stop them from growing or cause them to die.
Other targeted drugs include angiogenesis inhibitors and apoptosis inducers. Angiogenesis inhibitors limit the growth of new blood vessels required for tumor growth, while apoptosis inducers trigger cancer cell death.
How Do Targeted Therapies Treat Mesothelioma?
Several types of targeted therapies either help the immune system recognize cancer cells or block the growth of new blood vessels to fight mesothelioma. In the U.S., the two targeted therapy drugs approved to treat mesothelioma, Yervoy and Opdivo, target different cancer molecules.
Yervoy targets the CTLA-4 protein to promote the growth of T cells, immune cells that attack cancer cells. Opdivo targets the PD-L1 protein to block a cancer cell’s hiding ability. These therapies work together to enhance the immune system’s ability to find and kill mesothelioma cells.
Everyone’s DNA is different, and everyone seems to respond differently to treatment. I’ve been very fortunate with this. I just hope the good fortune continues.
Peter L., mesothelioma survivor
Oncology groups in the U.S. and France recommended adding a monoclonal antibody known as Avastin (bevacizumab) to improve chemotherapy outcomes in 2016 and 2017. Avastin inhibits a protein called vascular endothelial growth factor (VEGF), which limits the growth of new blood vessels that tumors need to grow and spread.
Combining different therapies is known as multimodal therapy. Another type of experimental targeted therapy, kinase inhibitors, is under preliminary investigation for mesothelioma. Kinase inhibitors also block the growth of new blood vessels. Researchers are also considering combining targeted therapies with gene therapy in future research.
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Targeted therapy’s common side effects include diarrhea and liver issues. Some people may develop a skin rash. Side effects vary depending on the type of targeted therapy prescribed.
Common Side Effects of Targeted Therapy
- Autoimmune reactions
- Bleeding or blood clotting issues
- Changes to your skin, hair and nails
- Diarrhea
- Eye problems
- Fatigue
- Heart damage
- High blood pressure
- Liver issues
- Rash
- Wound healing issues
Getting enough sleep, maintaining a healthy diet and exercising can help manage side effects. Quitting smoking and reducing alcohol consumption may also help to minimize adverse reactions.
Target therapy works against cancer cells, saving the normal cells from any damage. Using the body’s immune system, targeted therapy can block further growth of cancer cells or cause apoptosis (cancer cell death). Ongoing research is striving to determine how targeted therapy can help mesothelioma patients.
What to Expect When Getting Targeted Therapy
Your experience with targeted therapy depends on the type of therapy your mesothelioma doctor prescribes. Your body’s response to treatment also significantly shapes your experience with targeted therapy.
Small-molecule drugs are pills or capsules that you swallow, which means you can take them at home or while traveling. However, another type of targeted therapy, monoclonal antibodies, is administered intravenously through a needle in a blood vein. This type of therapy must take place in a hospital or cancer center.
Treatment frequency also depends on the drug, how advanced your cancer is and how your body responds. In general, you may receive treatment daily, weekly or monthly. Some targeted therapies involve cycles that include time between treatments for rest.
How to Prepare for Targeted Therapy
Preparing for targeted therapy varies depending on the type of drug administered. You can take oral treatments at home, but IV therapy must occur in a hospital or other medical facility.
Targeted therapies may interact with many common medicines and produce unwanted side effects. Tell your doctor about all the medicines you currently take, including prescriptions, supplements and over-the-counter pills. Ask if you should avoid certain vaccinations during targeted therapy.
You typically do not need to take precautions at home to protect loved ones while undergoing targeted therapy. Unlike chemotherapy, which may result in drug waste in bodily fluids, such as urine, vomit and sweat, targeted therapies don’t harm caregivers and household members.
Common Questions Associated With Targeted Therapies
- How is targeted therapy different from chemotherapy and immunotherapy?
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Chemotherapy drugs kill both cancer cells and normal cells, while targeted drugs only attack cancer cells. Certain forms of targeted therapy, such as monoclonal antibodies, are also considered immunotherapy.
- Is targeted therapy an FDA-approved treatment for mesothelioma?
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Yes, the two targeted therapy drugs approved to treat mesothelioma include Yervoy (ipilimumab) and Opdivo (nivolumab). They’re in a class of immunotherapy medications known as monoclonal antibodies.
- Is targeted therapy painful?
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While administration of targeted therapy is generally not painful, targeted drugs may cause painful side effects including skin rashes and pain in the muscles, bones and joints.
- Is targeted therapy expensive?
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Yes, the average annual cost of targeted therapy treatment is expensive and may exceed $250,000 a year. For example, the annual cost of Yervoy and Opdivo in 2018 was $350,646, according to a 2019 study published in JAMA Oncology.
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