Mesothelioma Patients Living Longer With New Drug Combinations

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In 2014, Russell Lamkins was told he had six months to a year to live after being diagnosed with mesothelioma. Six years later, Lamkins travels the US in his motor home with his wife. While mesothelioma has slowed him down, he reports he feels good.

Lamkins credits his longevity with deadly mesothelioma to the care he has gotten in a clinical trial at Moffitt Cancer Center in Florida. The center, based in Tampa, is two hours north of his home.

Lamkins, 74, said recently that the cancer center never made any promises. They said everything they were giving him was experimental. But he and his wife went back to the cancer specialist in his town, and all they offered was standard chemotherapy.

He decided to go back to Moffitt and was the second patient in a clinical trial in 2016 that offered a new therapy called transarterial chemoperfusion.

This innovative therapy involves giving a high amount of medicine to the cancerous tissue in the lung lining. Lamkins started this therapy after his mesothelioma got worse, even after intensive chemotherapy and immunotherapy.

Lamkins Exposed to Asbestos In Construction Industry

Mesothelioma is aggressive cancer caused by asbestos exposure, usually developing in the lung lining. People most at risk are construction workers, miners, shipbuilders, and railroad workers. Lamkins has worked in construction since the 1960s.

He noted in an interview recently that he worked heavily on roofing, drywall, insulating, and home remodeling. Much of the work involved demolition, and many of the old materials in the home contained asbestos. But he had no idea at the time.

Like many with pleural mesothelioma, Lamkins did not experience symptoms until the disease was in the later stages. Common symptoms include fatigue, weight loss, fever, loss of appetite, and chest pain.

Abdominal Mesothelioma Patient Thought Swollen Belly Was Only Old Age

In people where mesothelioma starts in the abdomen, patients can have belly pain or swelling symptoms. In Francine Schuman’s case, she thought her swollen belly was just a sign of age. But her abdomen began to swell, and she lost 20 pounds in a few weeks.

She had no idea she had cancer. In the hospital, they found a 4-centimeter tumor that was diagnosed as peritoneal or abdominal mesothelioma. Schuman believes the cancer was caused by inhaling talcum powder that she used on her children when they were infants.

Talc is mined near asbestos, so talc can sometimes be contaminated with small amounts of the carcinogen.

MARS 2 Clinical Trial To Study Surgery Plus Systemic Therapy

A new MARS 2 clinical trial will study how effective mesothelioma surgery is along vs. surgery and systemic therapy in 300 patients. The surgery to debulk the cancer is aggressive and challenging. Surgeons cut the ribs and remove most lining around the lungs and heart and replace it with a unique mesh. It is debatable how effective the surgery is, and the trial will help to determine this.

The study is enrolling people in the UK. In the study, scientists will study survival rates, quality of life, and cost in pleural mesothelioma people.

After the patients are enrolled, there will be 24 months of follow-up so that the clinical trial results will be known by the end of 2022.

More Encouraging Mesothelioma Treatments On the Horizon

Most encouraging right now is that in October 2020, FDA approved Opdivo and Yervoy, two immunotherapies to treat patients with pleural mesothelioma that cannot be resected with surgery.

The FDA approval was based on a Phase III clinical study’s conclusions that included 600 patients who received immunotherapy drugs or standard chemotherapy. Scientists noted a median survival of 18 months with the immunotherapy, compared with 14 months with chemotherapy. The immunotherapy also lowered the risk of death by 25%.

Immunotherapy is a good option because it may have fewer severe side effects than chemotherapy. Patients who receive immunotherapy may experience less vomiting and fewer problems with the kidneys. The treatment also does not require the person to sit for hours in a chemotherapy infusion center.

Also, data from a Phase II DREAM trial is looking good for patients with pleural mesothelioma. In at least 50 patients, immunotherapy used with chemotherapy works better than chemotherapy alone.

The Phase II clinical study Lamkins was involved in was presented at a medical conference in 2020. The study’s early results show a survival rate of 8.5 months and a disease control rate of 70%. Side effects with transarterial chemoperfusion are minor.

Another encouraging study involves gene therapy. The INFINITE trial is looking at an investigational drug combined with chemotherapy and anti-inflammatory drugs. The treatment is called Adenovirus Delivered Interferon Alpha 2b. In earlier studies, it lengthened patients’ lives by almost 18 months.

All of these innovative mesothelioma treatments offer hope for patients with one of the most aggressive cancers. Experts hope future clinical trials will continue to show promising results and extend the lives of thousands of cancer patients each year.