Malignant mesotheliomas are highly aggressive cancers, usually linked to asbestos exposure. Most patients survive approximately one year after diagnosis, and only seven percent of patients make it past five years. If not diagnosed early, these cancers are extremely difficult to treat. However, early diagnosis is a challenge because patients may be unaware of previous asbestos exposure or present with non-specific symptoms.
Research is currently underway to better understand how these cancers develop, and how to improve survival. The American Cancer Society and National Cancer Institute are good resources for information on ongoing clinical trials and enrollment criteria. Treatment options being researched can broadly be classified into radiotherapy, light or photodynamic therapy, drug or chemotherapy, biotherapy and immunotherapy. While radiotherapy is palliative in chest pain and chest wall spread, it has no effect on survival. Photodynamic therapy is being evaluated for earlier stages of malignant pleural mesothelioma; it combines the injection of a drug that makes cancer cells sensitive to light with the use of light of a certain wavelength to kill these cells.
A promising clinical trial showed patients with advanced malignant mesothelioma lived for nearly three months longer than a comparison group when treated with a drug combination of Alimtaä and cisplatin. The University of Chicago’s Cancer Research Center is leading a trial that combines the anti-cancer drugs gemcitabine and cisplatin, which kill cancer cells, with the biological agent bevacizumab, which slows the growth of cancerous tissue and blood vessels in this tissue. Researchers at the National Cancer Institute have identified a protein called mesothelin that is present in higher levels in mesothelioma cancer cells than in surrounding normal tissue. This knowledge is being used in ongoing clinical trials of vaccines that could kill cancer cells by triggering an anti-mesothelin immune response, and is also being used to develop diagnostic tests to detect rising mesothelin levels in people with malignant mesothelioma.
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