When Will Mesothelioma Be Cured? Exploring New Treatment Options

Mesothelioma is an aggressive cancer that currently has no cure and has limited treatment options. However, with a series of advances that make this trial “the world's first trial of anti-mesothelioma drugs,” Prof. Van Zandwijk and his team believe that TargoMirs will bring much-needed new and effective treatment to patients with mesothelioma. Surgery, chemotherapy, radiation therapy, and immunotherapy are the mainstays of mesothelioma treatment.

Combinations of these treatments are currently being tested and may provide the most promising option for some patients. Cryotherapy is a new treatment option for mesothelioma that uses sub-zero temperatures to kill cancer cells. Also known as cryoablation or cryosurgery, this targeted therapy has been shown to be effective in reducing the size of tumors and improving the symptoms of mesothelioma. However, it is important to note that total remission of mesothelioma is not a cure; there is no guarantee that the cancer will never return.

And newer types of treatment being tested in clinical trials may offer patients and their doctors even more options. Many patients have improved their prognosis and have even outgrown their mesothelioma through clinical trials. Jodi has survived pleural mesothelioma for several decades, while Paul has survived peritoneal mesothelioma for more than two decades. Immunotherapy is the best new treatment for mesothelioma.

Researchers believe in specific immunotherapy drugs called immune checkpoint inhibitors, which improve the immune system to fight mesothelioma. There are two approaches to immunotherapy: active immunotherapy, which uses drugs to improve the immune system; and passive immunotherapy, which adds laboratory-created proteins to what the body currently lacks. Checkpoint inhibitors and oncolytic viruses are types of active immunotherapy, while adoptive cell therapy and monoclonal antibodies are versions of passive immunotherapy. Both of these drugs are immune checkpoint inhibitors; Keytruda is approved for a small group of cases with high tumor burden.The FDA has not approved any other immunotherapy drugs for mesothelioma.

Mesothelioma Virotherapy Uses Viruses to Fight Cancer. Researchers harness the power of viruses by modifying them to be safe for healthy cells. The idea of virotherapy was developed more than a century ago; doctors observed that cancers decreased in patients who were infected with a virus.Tumor treatment fields are innovative cancer therapy combined with chemotherapy. The wearable device sends electrical waves through the body; these waves interrupt cell division and cause the death of diseased cells.The FDA approved NovoTTF-100L, now called Optune Lua, for unresectable malignant pleural mesothelioma; it is classified as a humanitarian-use device, which is for diseases affecting 8,000 people or less in the United States.

Malignant pleural mesothelioma meets these criteria.Photodynamic therapy uses light-reactive chemicals in drugs called photosensitizers. When light activates these chemicals, oxygen is released, killing nearby cancer cells. Photosensitizing drugs are administered intravenously and are absorbed by cancer cells; increased oxygen can prevent blood vessel formation, limiting nutrients for tumors and stopping the growth of tumors.Some side effects include skin rashes and sensitivity to light.Mesothelioma gene therapy sends a modified or laboratory-created gene to the patient's body. Gene therapy can restructure defective genes in cancer cells, add cancer-fighting genes, or block cancer genes.

Doctors give gene therapy drugs through viral vectors or bacteria; as healthy DNA enters the disease site, dysfunctional genes become functional or the body produces cancer-fighting proteins (such as the protein “interferon alfa-2b”). These proteins cause an immune reaction.Daniel Sterman believes in the power of gene therapy for mesothelioma; he hopes doctors can take mesothelioma “from a death sentence to a chronic disease that a patient can live with for years.”SMART for Mesothelioma is an innovative multimodal treatment protocol offered at select cancer centers in North America; SMART is the acronym for “surgery for mesothelioma after radiation therapy”. The multimodal therapy approach delivers radiation therapy to patients a few days before aggressive surgery; SMART is for malignant pleural mesothelioma and is not intended for peritoneal mesothelioma.Most cancer centers give radiation therapy to patients after surgery; Michigan Medicine is the first institution to offer the multimodal approach to the treatment of mesothelioma.Clinical trials explore many of these emerging therapies to test different combinations and new drugs. These studies offer patients with mesothelioma the opportunity to receive immunotherapy, gene therapy, or virotherapy medications that are not available in any general hospital or even most mesothelioma cancer centers.When qualifying for a clinical trial, a potential candidate must meet certain determinants such as a specific age or gender as well as have certain health requirements; this may depend on the type and stage of the mesothelioma.These studies are the best hope of finding a cure for mesothelioma, and you may contribute to finding the answer to this cancer.Some new treatment options help slow cancer growth; it is hoped that a therapy or combination of therapies can kill cancer quickly and decisively.

Doctors are trying different combinations of therapies such as photodynamic therapy, tumor treatment fields, gene therapy, virotherapy, and SMART.

Marissa Trafford
Marissa Trafford

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