Pleural mesothelioma usually occurs due to chronic inflammation from the inability of the body to handle the foreign antigens that are asbestos fibers. There are three subtypes of mesothelioma: epithelioid, biphasic and sarcomatoid.
Immune System
The immune system plays an important role in most cancers, including mesothelioma. Small surgical studies have suggested that tumor CD8+ T-cell infiltration leads to a better prognosis. A bigger study showed that infiltration of tumor CD4+ T-cell results in a better survival rate when it comes to epithelioid mesothelioma.
Due to their physical characteristics, asbestos fibers stay in the lung and other areas of the body and cause chronic inflammation. Because of this inflammation, immunocompetent cells may have their molecular and cellular features changed by interactions with asbestos fibers, which results in less tumor immunity.
Studies have shown that polymorphism in the genes that have to due with the metabolism or in DNA repair could play a vital role in both the pathogenesis and etiology of mesothelioma and other related diseases.
Registry
Italy has as National Mesothelioma Registry that promotes research projects for the evaluation of the link between mesothelioma and asbestos exposure, contributes to the evaluation of the effects, of the use of asbestos in industry, and to the realization of sources of contamination that are not known, to gather information on past asbestos exposure to asbestos of registered cases and lastly, to estimate the number of mesothelioma cases throughout the country. This is a useful wealth of information and it would be helpful for the US to implement a registry such as this.
Most forms of treatment for mesothelioma involve chemotherapy. There is also radiation therapy and surgery. Immunotherapy has been used more and more recently and immune checkpoint inhibitors have been of interest to doctors in fighting against mesothelioma to cause an anti-tumor immune response. There have been studies done to determine the effectiveness of these drugs.
Targeted therapy is also a tool that has been tried when it comes to treating mesothelioma. The most changed gene in malignant pleural mesothelioma patients is BAP1. 57 percent of cases include patients who are BAP1 deficient. Additionally, it is thought that 38 percent of patients are BRCA deficient.
Clinical Trials
Clinical trials have been used to assess the effectiveness of chemotherapy in conjunction with immunotherapy.
A study, titled Checkmate 743 showed benefits when combining immune checkpoint inhibitors. This clinical trial is no longer available, but its purpose was to “test the effectiveness and tolerability of the combination of Nivolumab and Ipilimumab compared to Pemetrexed and Cisplatin or Carboplatin in patients with unrespectable pleural mesothelioma.” (clinicaltrials.gov.) Those involved in the trial had to be diagnosed with malignant pleural mesothelioma and unable to undergo surgery. The study measured overall survival of patients participating in the clinical trial.
If you or a loved one has been diagnosed with mesothelioma or another asbestos-related disease, please call the Halpern Law Firm at (800) 505-6000 for legal help. Our experience enables us to help you get the compensation you deserve. For more information fill out our form.
Sources:
https://www.nature.com/articles/bjc2017269
http://www.mdpi.com/journal/environments
https://www.tandfonline.com/doi/pdf/10.2147/LCTT.S288535
https://clinicaltrials.gov/study/NCT02899299
Written By Sadie Gold
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