Clinical Trials for Mesothelioma Treatment: What are the Options?

Mesothelioma, a rare but aggressive form of cancer primarily caused by asbestos exposure, poses unique challenges in its treatment. Standard treatment regimens, such as surgery, radiation, and chemotherapy, can offer some patients extended survival and palliation of symptoms. However, they're not curative, and the quest for more effective interventions is ongoing. Enter the realm of clinical trials: the frontiers of medical research where new treatment possibilities are being rigorously tested. This article delves into the current landscape of clinical trials for mesothelioma, highlighting the promising options under investigation.

What are Clinical Trials?

Clinical trials are structured research studies that test the safety and effectiveness of new treatments, interventions, or tests, aiming to find better ways to treat, prevent, or diagnose diseases[1]. They often follow a phased approach: from Phase 1 (assessing safety and dosage) to Phase 4 (post-market surveillance). For mesothelioma patients, participating in clinical trials may offer access to cutting-edge treatments that are not available through conventional channels.

Emerging Treatments in Clinical Trials for Mesothelioma

1. Immunotherapy:

Immunotherapy focuses on harnessing the body's immune system to fight cancer. In mesothelioma, several immunotherapy agents are under investigation, either as standalone treatments or in combination with other therapies. Notable examples include immune checkpoint inhibitors such as pembrolizumab (Keytruda) and nivolumab (Opdivo). These drugs block proteins that prevent immune cells from attacking cancer cells, potentially increasing the immune response against the tumor[2].

2. Gene Therapy:

Gene therapy explores altering the genetic makeup of cells to combat or prevent disease. In mesothelioma, researchers are investigating ways to introduce genes into the body that can either help the immune system target cancer cells or cause cancer cells to self-destruct[3].

3. Targeted Therapies:

Instead of attacking all rapidly-dividing cells (like chemotherapy), targeted therapies focus precisely on the cancer cells. By identifying and targeting specific molecules that are crucial for the cancer's growth and survival, these drugs aim to reduce side effects and increase effectiveness. Examples include drugs targeting angiogenesis (the formation of new blood vessels that feed tumors)[4].

Clinical Trials for Mesothelioma Treatment What are the Options

4. Tumor Treating Fields (TTF):

TTF is a novel non-invasive treatment approach using electric fields to disrupt cancer cell division. A device worn by the patient creates these fields, targeting cells in the tumor while causing minimal damage to healthy cells[5].

5. Photodynamic Therapy (PDT):

PDT involves a two-step process: the introduction of a photosensitive drug into the body, followed by the targeted exposure of the tumor to specific light wavelengths. The light activates the drug, producing a form of oxygen that kills the cancer cells[6].

Benefits and Risks

For patients with mesothelioma, clinical trials can offer hope, especially if standard treatments are no longer effective. Participation can mean access to groundbreaking treatments and meticulous medical care from leading specialists. Moreover, these patients play a vital role in advancing mesothelioma research and potentially improving outcomes for future patients.

However, there are inherent risks. The experimental treatments may not always be effective, or they might be less effective than current standard treatments. Additionally, unexpected side effects can emerge. It's crucial for patients to discuss the potential benefits and risks with their medical team and loved ones before making a decision[7].

Conclusion

Clinical trials for mesothelioma treatment represent the pioneering edge of medical research. They provide valuable avenues for patients seeking alternative treatments and contribute immensely to the broader understanding of the disease. As science and medicine continue to evolve, it is these trials that will pave the way for more effective and innovative treatments for mesothelioma and other challenging diseases.

Bibliography:

[1]: National Cancer Institute. (2021). What Are Clinical Trials? (https://www.cancer.gov/about-cancer/treatment/clinical-trials/what-are-trials)

[2]: Alley, E. W., Lopez, J., Santoro, A., Morosky, A., Saraf, S., Piperdi, B., & van Brummelen, E. (2017). Clinical safety and activity of pembrolizumab in patients with malignant pleural mesothelioma (KEYNOTE-028): preliminary results from a non-randomised, open-label, phase 1b trial. The Lancet Oncology, 18(5), 623-630. (https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(17)30169-9/fulltext)

[3]: Sterman, D. H., Recio, A., Vachani, A., Sun, J., Cheung, L., DeLong, P., ... & Albelda, S. M. (2015). Long-term follow-up of patients with malignant pleural mesothelioma receiving high-dose adenovirus herpes simplex thymidine kinase/ganciclovir suicide gene therapy. Clinical Cancer Research, 21(23), 5480-5488.

[4]: Jahan, T. M., Guzman, M. A., Batra, R. K., & Dubinett, S. M. (1998). Current approaches and future strategies in the targeted therapy of metastatic malignant mesothelioma. Seminars in Oncology.

[5]: Tumor Treating Fields: TTFields. (n.d.). Novocure. (https://www.novocure.com/our-therapy/)

[6]: Friedberg, J. S. (2016). Photodynamic therapy as an innovative treatment for malignant pleural mesothelioma. Seminars in Thoracic and Cardiovascular Surgery, 28(1), 165-170.

[7]: Baas, P., Scherpereel, A., Nowak, A. K., Fujimoto, N., Peters, S., Tsao, A. S., ... & Cedres, S. (2021). First-line nivolumab plus ipilimumab in unresectable malignant pleural mesothelioma (CheckMate 743): a multicentre, randomised, open-label, phase 3 trial. The Lancet, 397(10272), 375-386. (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32714-8/fulltext )