Mesothelioma

Mesothelioma is known for having a very poor prognosis. Caused by asbestos exposure, symptoms often don’t begin to show until 20 – 50 years later. Unfortunately, this long latency period means many patients aren’t diagnosed until the disease has progressed to a later stage. Mesothelioma is difficult to treat, and in later stages it becomes even more grueling. In many instances, mesothelioma specialists will recommend a multimodal approach to treatment, meaning a combination of standard therapies like surgery with chemotherapy. Emerging therapies have also begun to give patients hope. Immunotherapy, a treatment that boosts the immune system to fight cancer, has shown promise as an effective treatment for mesothelioma. Last September, a new mesothelioma clinical trial began at the Baylor College of Medicine Mesothelioma Treatment Center. The clinical trial is a new multimodal approach that looks at the effectiveness of immunotherapy applied before surgery for pleural mesothelioma patients. Though the trial is still in its early stages, researchers are encouraged by the results so far. Promising Early Results Typically, immunotherapy has been approached as a stand-alone treatment method or an adjuvant therapy after surgery. This clinical trial is one of the first to study the use of immunotherapy as a neoadjuvant therapy, or a so-called helper treatment used before the primary treatment method. Researchers are studying and comparing two variants: MEDI4736 alone versus MEDI4736 combined with tremelimumab. The first has one checkpoint inhibitor, while the second consists of two types of checkpoint inhibitors. A checkpoint inhibitor blocks the negative signals tumors display, thus reactivating the immune system to target the tumor cells. After receiving one of these therapies, patients will then undergo surgery to remove any visible tumors. Before the immunotherapy is administered and following surgery, researchers will study the immune response of these tumors. When the trial was first announced in the fall, Dr. Bryan Burt, the lead investigator, explained how their data suggests pleural mesothelioma tumors could be more immunogenic (capable of producing an immune response) than previously believed. He predicted that immunotherapy could become a critical component for multimodal treatments in mesothelioma in the future. Recently, Dr. Burt told the Mesothelioma Cancer Alliance (MCA) that the early results of the trial are very encouraging. “We have seen that our patients are tolerating checkpoint inhibitor immunotherapy very well in the preoperative setting, and we are now beginning to look at how these drugs are influencing the immunologic environment within the tumor, which we believe can favorably influence long-term clinical outcomes.”