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Mesothelioma and Immune Checkpoint Inhibitors

About 3,000 people are diagnosed with mesothelioma annually in the United States. However, these are only the instances that are registered in the coding system, and it is thought that the true number of cases is more. In fact, approximately 20% to 25% of cases are coded incorrectly and are therefore not recorded in statistics. Since the United States population is growing, despite the percentage of population with mesothelioma decreasing, the number of cases per year remains fairly consistent or increases.

The word asbestos was formed from a Greek word that means, “inextinguishable” and the material has been used for potentially the past 5,000 years. Inhaling asbestos can cause mesothelioma, the most common form being malignant pleural mesothelioma. Malignant pleural mesothelioma has come in waves throughout the decades. The first wave of incidences of mesothelioma resulted from milling, mining and transporting raw asbestos. The second wave of mesothelioma came from more industrial uses, like insulating, shipping, manufacturing, engineering, carpentry, electrical, boilermaker, railway, armed services and cement industries. The third wave came from repairing and renovating old buildings that had asbestos-containing materials in them.

Mesothelioma has not disappeared after the implementation of rules and regulations regarding the handling of asbestos. Conversely, the number of cases and deaths in both developing countries and countries with many resources are increasing. This is due to a multitude of reasons. One of the reasons is that people are living longer, and due to its latency period, people do not tend to get diagnosed with mesothelioma until later in life. Also, asbestos already exists in many places from when it was used industrially. These are just a couple of reasons.

Immune Checkpoint Inhibitors

Immune checkpoint inhibitors (ICIs) can cause improved outcomes when administered to patients with mesothelioma. The immune system uses “checkpoints” that must be turned on or off to start an immune response. Cancer cells also sometimes use checkpoints to prevent themselves from being attacked by the immune system. More recent drugs that have been established over the past several years are called immune checkpoint inhibitors and they work by targeting the checkpoint proteins in order to restore the immune response towards the cancer cells.

There are different types of checkpoint inhibitors that are being used. There are PD-1 inhibitors and a CTLA-4 inhibitor. Pembrolizumab and nivolumab are two drugs that target PD-1, which is a protein on immune system cells, referred to as T cells. This can shrink or slow the growth of tumors by making the body’s immune response better suited to respond against cancer cells. Both of these drugs are administered through an IV. Ipilimumab blocks a protein on T cells called CTLA-4 and it is also administered through an IV.

Side Effects

Immune checkpoint inhibitors come with some side effects. These include nausea, cough, fatigue, itching, skin rash, decreased appetite, joint pain and more. It is also possible to get an infusion reaction from the administration of the drugs, which may include dizziness, rash, itchy skin, wheezing, feeling dizzy, flushing of the face, fever, chills and trouble breathing. There may also be autoimmune reactions, which occur if the immune system starts to attack other parts of the body. This can cause issues in the lungs, liver, intestines, hormone-making glands, kidneys and other organs.

Immunotherapy is either active or passive. Active immunotherapy is when the goal of the treatment is to stimulate the patient’s immune system, most commonly through vaccination. Passive immunotherapy is when immune effectors are isolated in vitro prior to being administered to the patient. Studies on immunotherapy treatment on mesothelioma patients have been going on for over 25 years.

If you or a loved one has been diagnosed with mesothelioma, call the Halpern Law Firm at (800) 505-6000. With over 30 years of experience and over $100 million won for our clients, we are here to help get you the compensation you deserve.

Sources:

https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.21572

https://www.mdpi.com/2072-6694/13/16/4194

https://www.cancer.org/cancer/types/malignant-mesothelioma/treating/immunotherapy.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082257/

Written By Sadie Gold

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