Researchers Review of Mesothelioma Treatment Options Identifies Many Reasons for Hope

Even though mesothelioma is rare as cancers go, researchers have paid it quite a bit of attention over the years.

They want to understand this unusually aggressive cancer so that they can find a cure. Or, if they can’t find a cure, then they want to find better therapies to help mesothelioma patients live as long as possible.

The researchers engaged in these efforts are working every angle they can think of. Fortunately, there are a lot of angles to work when the research target is mesothelioma.

So many, in fact, that a team of researchers from the University of Texas Southwestern and the Veterans Affairs North Texas Healthcare System decided it might be advantageous to pause, look around and take stock of the current situation.

They published their assessment in the May 2016 issue of the journal Lung Cancer: Targets and Therapy. Here is some of what they reported.

Extending Mesothelioma Survival

First, a cure for mesothelioma remains beyond reach for now. So researchers are mainly working to extend mesothelioma survival rates.

With survival extension in mind, many mesothelioma researchers are seeking deeper understanding of the inability of the BAP1 tumor suppressor gene to prevent mesothelioma and stop it from spreading.

This failure stems from a mutation of BAP1, the researchers say scientists now recognize. One study cited by the researchers estimated that BAP1 mutations are present in approximately 60 percent of the people who develop mesothelioma.

The researchers noted that mesothelioma shows up as one of three main types when it strikes. They are epithelioid, biphasic and sarcomatoid. Epithelioid is the most common type and also the one that responds best to current forms of treatment.

The researchers reflected on the fact that there is a consensus regarding use of multidisciplinary teams to treat mesothelioma. The majority view is that multidisciplinary teams deliver better results.

The researchers went on to summarize the three primary ways by which mesothelioma can be treated. The first of these is surgery. As the researchers pointed out, surgery is not appropriate for every mesothelioma patient — those who meet the criteria for it are usually in an early stage of the cancer.

Surgery seeks to remove all of the mesothelioma that the surgeon can see and access. Because some of the mesothelioma is not readily visible or is in a place the knife can’t reach, surgery is usually performed in conjunction with the second treatment type — chemotherapy.

Chemotherapy as a standalone treatment is given to mesothelioma patients at all stages of the disease, the researchers said. Chemotherapy can be administered using a single agent, but the researchers spotlighted studies showing that chemotherapy can work better if two agents are given instead.

Mesothelioma Immunotherapy Research

The third main treatment type discussed by the researchers is radiation therapy. Radiation is customarily administered as an adjunct to surgery or chemotherapy but almost never by itself.

The researchers also looked at a fourth type of mesothelioma treatment — immunotherapy. This is an up-and-coming form of intervention. Much research energy is concentrated on it just now, the researchers said.

One particular immunotherapy strategy of interest involves the targeting of immune checkpoints such as PD-L1 and PD1 with immunomodulatory monoclonal antibodies, they reported.

The researchers from the University of Texas Southwestern conclude from their survey that efforts to develop immunotherapies must be continued and intensified owing to the potential they possess.

The title of the researchers’ journal article is “Modern Management of Malignant Pleural Mesothelioma.”