It’s long been clear that pleural mesothelioma is a difficult cancer to treat. However, scientists and doctors continue their research into the disease, hoping to discover new drugs or therapies to address this aggressive cancer or find ways to improve current treatments.
Scientists have been studying pleural mesothelioma since the early decades of the 20th century when the link between asbestos and cancer was first discovered. It’s a complex disease that has resulted in plenty of head-scratching and less than exemplary results when it comes to finding better ways to treat it.
It’s essential for researchers to understand exactly how asbestos exposure causes the cell changes that lead to pleural mesothelioma. And because not everyone who is exposed to high amounts of asbestos develops pleural mesothelioma, scientists are also trying to determine what possible roles other factors, such as genetics, play in the development of the disease.
Mesothelioma’s resistance to traditional chemotherapy drugs has also been an important issue for researchers to address. Though they’ve zeroed in on some potential clues – such as a protein that is found in greater concentration in mesothelioma cancer cells than in non-cancerous cells - researchers still have a long way to go when it comes to understanding the molecular biology of this rare form of cancer.
The most notable drug to come out of pleural mesothelioma research in the last several years is Alimta®. Manufactured by Eli Lilly, it is the only FDA-approved drug specifically designed for the treatment of mesothelioma. Combined with a platinum agent, it has showed great promise in the treatment of the disease, helping to extend life expectancy, even if only for several months.
Researchers are also currently experimenting with a class of drugs known as anti-angiogenesis medications. These drugs aim to stop the growth of blood vessels in cancerous tumors, therefore stopping the tumors themselves from growing. Pleural mesothelioma patients would benefit from this drug as mesothelioma generally spreads very quickly and these drugs could essentially starve these tumors and halt the metastases. Bevacizumab (Avastin) is an example of an anti-angiogenesis drug being tested for use with mesothelioma patients.
Anti-growth factor drugs like Erlotinib (Tarceva) are also being tested on mesothelioma patients. They can kill cancer cells by interfering with substances the cells need to grow, also stopping the spread of the disease.
Clinical trials are currently being conducted for the enzyme Ranpirnase (Onconase). Ranpirnase breaks down the RNA in mesothelioma cells. Its use has shown some promise during trials, slightly increasing the life span of those who took the drug.
Another medication that aims to inhibit an enzyme that regulates histones (proteins that control DNA) is currently being tested. This medication, suberoylanilide hydroxamic acid (vorinostat, [SAHA]), may indeed help kill cancer cells though not enough evidence has been collected.
Multimodality (combination) treatments combine surgery, chemotherapy and/or radiation to offer the best possible treatment for pleural mesothelioma patients. Unfortunately, surgery is often not an option for pleural mesothelioma patients because the disease is too far advanced when it is diagnosed. Many patients, however, do receive a combination of chemotherapy and radiation, a regimen that can be very hard on the body. Scientists and doctors are constantly in search of better ways to combine treatments so that the patient suffers as few side effects as possible. This may include new drugs as well as new ways of delivering more targeted radiation that spares healthy cells.
Research focused on using the body’s own immune system to fight cancer cells has also shown some significant promise. Known as immunotherapy, this type of cancer treatment comes in two forms: active and passive.
Another form of immunotherapy is better known as gene therapy. Some clinical trials using gene therapy have been specifically aimed at pleural mesothelioma patients. For this treatment, notes the American Cancer Society, genetically modified viruses are injected into the pleural space. The viruses infect the mesothelioma cells and introduce the gene for interferon-beta into the mesothelioma cells. Interferon-beta is an immune system hormone and the goal of the therapy is to get the body’s own immune system to attack the pleural mesothelioma cells. Again, gene therapy has shown some promise in the treatment of this hard-to-fight cancer.
Newly diagnosed pleural mesothelioma patients have more reason than ever to feel hopeful about their prognosis. Though there’s still a long way to go, more and more drugs and therapies are being created to address this rare form of cancer and the American Cancer Society notes that they expect five-year survival rates for those with pleural mesothelioma to increase within the next several years.
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