Is There a Cure for Mesothelioma?

Unfortunately, mesothelioma remains uncured. Nevertheless, surgical interventions coupled with localized chemotherapy have ushered some patients into long-term remission, a feat not achieved with standalone therapies. The prognosis depends on cancer stage and type, with earlier diagnoses offering a more favorable outlook. Notably, peritoneal mesothelioma boasts a longer life expectancy compared to its counterparts.

For instance, a study melding surgery and diverse chemotherapy regimens resulted in an astonishing median survival of 14.8 years for peritoneal mesothelioma patients. Another study, involving surgery and heated intraperitoneal chemotherapy (HIPEC), yielded an impressive median survival of 8.3 years. Pleural mesothelioma patients initially undergoing chemotherapy followed by surgery and additional chemotherapy achieved a median survival of approximately 5 years. Remarkably, 70% of these patients lived a year or more sans tumor growth.

It’s paramount to stress that these estimated survival times are often outlived. Heather Von St. James, a pleural mesothelioma survivor, initially given 15 months to live, has surpassed her prognosis, thriving for over 17 years. Her journey inspires countless mesothelioma patients.

Current Mesothelioma Treatments

• Chemotherapy: Employed for inoperable cases, chemotherapy extends survival, with pleural mesothelioma patients enduring chemotherapy alone enjoying a median survival of 16.4 months. It’s also a linchpin in multimodal treatments aimed at prolonging life.
• Immunotherapy: Immunotherapy, exemplified by Keytruda®, holds promise, particularly for patients ineligible for conventional therapies. Pleural mesothelioma patients treated with Keytruda® achieved a median survival of 18 months.
• Radiation Therapy: Typically utilized in tandem with other treatments, radiation therapy can palliate or target cancer progression. Palliative radiation therapy for pleural or peritoneal mesothelioma led to a median survival of approximately 12 months.
• Surgery: Surgery, encompassing cytoreductive surgery (CRS) to shrink tumors, is pivotal in multimodal approaches. Pleurodesis, preventing lung fluid buildup, exhibited promise, with patients surviving a median of 12 months.

Collaboration with dedicated mesothelioma specialists is paramount. They tailor treatment plans, often embracing multimodal approaches, elevating patient life expectancy.

Multimodal Treatments Extend Survival

Multimodal therapies, blending various treatments, remarkably extend survival, occasionally tantamount to functional cures—years of mesothelioma-free life. Notable multimodal therapies achieving extended median survival times encompass:

• Pleural Mesothelioma: The amalgamation of extrapleural pneumonectomy (EPP) surgery, chemotherapy, and radiation led to a remarkable median survival of 39 months (approximately 3.25 years). Notably, Alimta® (pemetrexed) and cisplatin featured as chemotherapy stalwarts.
• Peritoneal Mesothelioma: Pairing cytoreductive surgery with heated intraperitoneal chemotherapy (HIPEC), early postoperative intracavitary chemotherapy (EPIC), and normothermic intraperitoneal chemotherapy (NIPEC) resulted in an astonishing median survival of 14.8 years.

Researchers persistently refine multimodal therapies, holding the promise of enhancing patient prognosis.

Emerging Mesothelioma Treatments

The mesothelioma research arena evolves continuously, casting a hopeful shadow with emerging treatments poised to extend patient survival and bolster prognosis. These avant-garde treatments undergo clinical trials, potentially becoming integral to standard mesothelioma care.

Tumor Treating Fields (TTFields)

TTFields harness mild electric stimulation to disrupt cell division and impede cancer cell growth. A study evaluating TTFields in pleural mesothelioma patients reported encouraging outcomes, with 40% experiencing tumor shrinkage, and 57% observing arrested tumor growth. The FDA’s approval of Optune Lua™ for unresectable pleural mesothelioma underscores TTFields’ potential.

Herpes Simplex Virus (HSV)

Oncolytic virus therapy exploits a modified herpes virus (HSV-1716) to assail cancer cells while sparing healthy ones. A British study investigating HSV therapy for mesothelioma demonstrated promise, with 46% of patients achieving disease stability and no tumor growth.

Gene Therapy

Gene therapy employs bioengineering techniques to modify cell DNA. In one study, gene therapy emerged as a potential treatment for surgery-ineligible patients. Researchers tinkered with pleural cells’ DNA, inducing interferon-alpha protein production, which retards cancer cell growth and boosts the immune system’s cancer-killing prowess. Patients receiving gene therapy alongside chemotherapy survived a median of 26 months.

Small Molecules

Small molecule drugs, with their capacity to penetrate cells effortlessly due to low molecular weight, tantalize researchers. Ganetespib, a small molecule drug, exhibited promise alongside pemetrexed and platinum-based chemotherapy for pleural mesothelioma, resulting in a median survival of 16.3 months.

Notably, in October 2020, the FDA greenlit an immunotherapy treatment combination comprising Opdivo® (nivolumab) and Yervoy® (ipilimumab) for pleural mesothelioma. This groundbreaking approval marked the first in over 15 years for systemic pleural mesothelioma treatment, culminating in a median survival of 18.1 months.

Ongoing research continues to unravel these treatments, offering optimism for mesothelioma patients. Clinical trials beckon, providing eligible patients the opportunity to contribute to advancing the field.

Ongoing Mesothelioma Treatment Research

Dedicated research marches onward, kindling hope for a mesothelioma cure. Beyond pioneering treatments, ongoing investigations refine existing therapies, enhance early detection methods, and elevate patient care and quality of life.

The National Cancer Institute (NCI) stands at the forefront, channeling funding to universities, hospitals, labs, and research institutions nationwide. Clinical trials spearhead treatment and detection enhancement efforts, with early detection research centered on biomarkers. Biomarkers, objective indicators, hold promise in identifying cancerous and precancerous cells before they progress. Noteworthy biomarkers for mesothelioma include ENOX2, mesothelin, and HMGB1, with MESOMARK™ serving as the sole FDA-approved mesothelioma test to date.

Clinical trials, frequently in collaboration with NCI-designated cancer centers, constitute pivotal conduits for advancing treatments and detection methodologies. These trials usher in:

• Extended patient survival
• Enhanced management of treatment side effects
• Improved patient quality of life
• Elevated cancer care quality

Despite the obstacles stemming from mesothelioma’s rarity and the challenges of early-stage research, steadfast mesothelioma researchers persist in their quest for enhanced treatments and, ultimately, a cure.

While mesothelioma continues to present formidable challenges, current treatments, emerging therapies, and ongoing research efforts collectively shine a ray of hope. Mesothelioma patients, their families, and the medical community stand unwavering in their pursuit of improved outcomes, extended survival, and, ultimately, the triumph over mesothelioma.