Mesothelioma is aggressive cancer with no availability of curative treatment. The only way to cure a mesothelioma patient is an early diagnosis, which is often not possible due to the long dormancy period of this cancer. Over the years, doctors have been using many treatments such as surgery, chemotherapy, and radiation to improve symptoms. For developing a treatment plan, doctors often consider many factors such as the location of cancer, the type of mesothelioma cancer cells, the overall condition of the patients, and the stage and the extent of cancer.
In their pursuit to develop a cure for mesothelioma patients, medical science has been developing new treatments that promise to improve a patient’s symptoms and prognosis. Continuous efforts have also resulted in better diagnosis technologies and methods, improvements in traditional treatments, and the introduction of new ones.
If you or your relative are facing difficulty due to mesothelioma, here is a list of new treatments that you should ask your doctor about.
Improvement in the traditional treatments
Researchers have not stopped their efforts of introducing innovations and improvements in the currently available treatments. They have also been employing these treatments in multi-treatment plans for progressive patient outcomes.
Traditionally, the surgical options for treating mesothelioma patients included extrapleural pneumonectomy (EPP) and pleurectomy and decortication (P/D). However, in recent years, doctors have been using cytoreductive surgery (CRS) coupled with hyperthermic intraperitoneal chemotherapy (HIPEC) to treat peritoneal mesothelioma patients. So far, this treatment has improved the life expectancy of patients. In one instance, 50 patients included in a study received this treatment and experienced a median overall survival of 97.8 months. However, this treatment needs further research to test the effectiveness for peritoneal mesothelioma patients in the later stages. Moreover, researchers are also analyzing if the inclusion of heated chemotherapy or cryotherapy with specific surgical procedures will improve patient outcomes.
2. Bevacizumab in chemotherapy
The most substantial development in chemotherapy is the successful use of Bevacizumab, commonly sold by Avastin. Pleural mesothelioma patients have improved survival rates due to the addition of this drug in the standard chemotherapy drug combination (pemetrexed and cisplatin). In one study, patients showed a median survival of 18.8 months when treated with pemetrexed, cisplatin, and Bevacizumab compared to 16.1 months in the prior combination.
Intensity-modulated radiotherapy (IMRT) is one of the most recent and successful additions to mesothelioma radiation. This is now becoming the most common type of therapy used for mesothelioma patients. A study reveals that the use of IMRT before the surgical procedure of extrapleural pneumonectomy prolongs a patient’s median overall survival rate to 36 months. However, the average life expectancy of patients with malignant pleural mesothelioma is 6 to 12 months.
Emerging mesothelioma treatments
In addition to many changes occurring in the traditional treatments, there have been various new testings for emerging therapies. These are tested as adjuvant, neoadjuvant, first-line, and second-line treatments. Here is a list of some promising treatments introduced to cure cancer patients.
3. Cancer vaccine
A cancer vaccine uses the patient’s cancer cells and immune system to treat mesothelioma. This vaccine uses the memory of patients’ immune systems to treat cancer in the body, hoping that treatment will continue to work after vaccination. So far, FDA has not approved any vaccine to cure cancer patients, but clinical trials with the use of therapy have shown some degree of success.
Using a dendritic cell cancer vaccine has shown optimistic results in one trial. Ten patients received a dose of this vaccine, and seven out of ten have gained a survival of 24 months. Among the seven patients showing positive results, two survived 50 and 66 months after receiving the vaccination.
Keytruda® is neither radiation nor chemotherapy; instead, it is an immunotherapy that works with a patient’s immune system to fight cancer. It is a medicine that works as an immune checkpoint inhibitor. It blocks the PD-1/PD-L1 gene pathway allowing the immune system to identify and destroy cancer cells. Currently, the FDA has approved this drug to treat non-small cell lung cancer, a kind of skin cancer called melanoma, head and neck squamous cell cancer, and classical Hodgkin lymphoma (cHL), to name a few. The drug has not specifically been approved for mesothelioma treatment, but it has shown positive results in clinical trials.
5. Photodynamic Therapy
Photodynamic therapy is another emerging treatment. The treatment uses light-sensitive drugs, activated upon being exposed to some light. When activated, these drugs destroy the cancer cells and prevent the spread of cancer (metastasis). Doctors can use a photodynamic medication that strengthens the immune system response in the patient’s body and, when activated, delays the growth of the tumor. This therapy has significant potential for enhancing the patients’ immunity making their bodies stronger to fight mesothelioma. It has shown even better results when combined with other treatments like surgery. One of the highlights of this treatment is that it has significantly low side effects.
6. Epigenetic Therapy
It focuses on how DNA expression leads to changes in the body. Various factors such as age, environment, and diet cause the DNA to express the genes differently. The current mesothelioma treatments include epigenetic targets UHRF1 and inflammation biomarkers. Asbestos fibers, the primary cause of mesothelioma, also lead to an epigenetic effect causing inflammation and DNA destruction leading to cancer formation. Some studies show that epigenetic alterations might be why mesothelioma patients do not respond to chemotherapy medications.
In response to changes caused by asbestos fibers, Epigenetic therapies can reverse the damage and promote the normal expression of DNA genes. A recent study in 2021 shows the impact of epigenetic effects on the survival rate of pleural mesothelioma patients—aligning with prior studies.
7. Anti-Angiogenic Drugs
These drugs are another emerging mesothelioma treatment that targets the growth of blood vessels in cancer. This treatment is carried out against Angiogenesis. New blood vessels grow, which supply oxygen and nutrients to the tumor cells allowing cancer to grow and spread. This way, the treatment aims to thwart the cancer development and spread.
Today, oncologists treating mesothelioma patients are not limited to using traditional treatments. There have been improvements in the conventional methods, and new treatments are also emerging. In many cases, clinical trials show positive results, which calls for further study for these treatments to be trustworthy for critically ill mesothelioma patients.