Mesothelioma is usually highly resistant to treatment and is very aggressive. It is essential that research continues to be conducted to determine the best treatment options for mesothelioma patients both in the early stages and later stages of the disease. We are just now seeing the peak of the incidence of mesothelioma as there is a long latency period from exposure to asbestos and the development of the disease. It can take 30-40 years after exposure to asbestos for someone to be diagnosed with mesothelioma.
When it comes to mesothelioma, the goal of surgery is commonly macroscopic complete resection. However, surgery does not cure the patient of cancer and it is usually used as a multimodal approach, combining chemotherapy and/or radiation therapy.
New Approaches to Radiation Therapy
New ways to administer radiation therapy are being tested using intensity-modulated techniques. A study conducted by Rimner et al. demonstrated that hemithoracic intensity-modulated pleural radiation therapy after chemotherapy and pleurectomy decortication surgery was safe in patients who had malignant pleural mesothelioma. This trial was only done on 27 patients, therefore there are more trials that need to be done to determine the effectiveness of this treatment approach.
Intrapleural Therapies
Other treatment techniques that have been investigated are intrapleural therapies with the goal of improving the local control of the mesothelioma by administering drugs directly on the surface of the tumor(s). Different techniques that have been used include gene therapy, hypertermic intrapleural chemotherapy, interpleural immunotherapies, and photodynamic therapy.
Neoadjuvant Trials
There are neoadjuvant trials, meaning treatment before surgery, involving immune checkpoint inhibitors. Immune checkpoint inhibitors are also tested in the adjuvant setting, meaning after surgery, with the goal of reducing immunosuppression caused by tumors. Immunosuppression is the partial or complete suppression of the immune response of an individual. This can happen naturally or due to a disease or another condition or can be artificially induced to aid in the survival of an organ or after a transplant operation.
Unresectable Mesothelioma
For unresectable mesothelioma, or mesothelioma that cannot be removed via surgery, there are a multitude of treatment paths one can take depending on the aggressiveness of the cancer. In general, chemotherapy in some form is usually used to treat victims of mesothelioma.
Through recent studies, there has been an accurate genomic (the complete set of genes in a cell or an organism) profiling of mesothelioma. Analysis of this profiling may aid in figuring out a more targeted approach to mesothelioma treatment.
There have also been studies regarding mesothelin targeted therapies. The mesothelin is a tumor differentiation antigen that is usually present on the mesothelial cells that line the pleura, peritoneum, and pericardium- all places in which mesothelioma can originate.
The immune system is an important factor when it comes to mesothelioma. Locally induced immune suppression caused by the mesothelioma tumor is high. It may be of use to combine immune checkpoint inhibitors with targeted therapies, antiangiogenic agents, radio therapy, or immune-modulatory molecules.
Because the immune system plays a role in mesothelioma growth, vaccines may be of use when it comes to treatment options. Vector and cell-based vaccines as well as protein-based vaccines have been tested in malignant pleural mesothelioma.
Other emerging therapies include T cell therapies and virotherapy.
In conclusion, it is evident that there are ongoing clinical trials and studies taking place to determine new treatment options that can be used to treat mesothelioma, which is a good thing. That being the case, there is still more research that needs to be done in order to truly determine the best treatment based on the stage of mesothelioma a patient is experiencing.
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 or for more information. You can also fill out our form. We have helped so many clients get compensation, and we want to do the same for you.
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Written By Sadie Gold
