Mesothelioma is an aggressive and difficult to treat cancer. Surgery, radiation, and chemotherapy are not always completely effective, so alternative therapies have been developed.
One of the most promising new therapies is immunotherapy. It is not yet a first-line treatment for mesothelioma, but scientific research may someday make it a reality. (asbestos.com)
Some immunotherapy drugs, such as Ketruda, are helping some patients live with mesothelioma for years. (Sciencedaily.com). Ketruda is available to people with mesothelioma through compassionate use programs and clinical trials. Keytruda is also approved by the FDA for many types of cancer.
Immunotherapy can be effective in mesothelioma by enhancing the immune system response to the disease. But immunotherapy cannot cure the cancer. Scientific research is in the process of integrating immunotherapy as part of a multimodal treatment plan to manage mesothelioma as you would a chronic disease.
How Immunotherapies Work
The immune system is designed to protect your body from foreign pathogens, such as bacteria and viruses, and the development of diseases. It also gets read of dead or damaged cells, including cancerous ones.
Immunotherapy drugs are either active or passive. Active immunotherapy makes a change in the immune system. It teaches your immune system how to recognize the mesothelioma tumor permanently. After the initial treatment, the immune system remembers to see the cancer cells as an enemy to attack. This is usually because the patient has made their own antibodies against the mesothelioma. (mesotheliomaguide.com)
Passive immunotherapy has no lasting memory. Once treatment is stopped, the treatment effect goes away. The body has a temporary response, such as when your immune response is activated by external antibodies being present.
Examples of passive immunotherapies are monoclonal antibodies that are used in Keytruda and Optivo.
Which Immunotherapies Are Effective Against Mesothelioma?
Several immunotherapy drugs, such as Yervoy, Opdivo, and Keytruda, are available to patients. Each drug has shown promise against mesothelioma in various clinical trials. (Cancer.org)
Keytruda usually is used on lung cancer and it is being studied as a possible therapy drug for mesothelioma. Clinical trials suggest that Keytruda is effective against mesothelioma in some patients.
It can help these patients to live longer if cancer recurs after first-line treatments are ineffective. One survivor of asbestos cancer claims that Keytruda and surgery saved his life, while another claimed that chemotherapy and Keytruda saved his life.
SEE ALSO: Mesothelioma vs Lung Cancer Differences
The immunotherapy drugs Opdivo and Yervoy can help patients live longer after their mesothelioma recurs. This means these drugs could be more effective than chemotherapy as a second-line treatment.
It is reported that less than ⅓ of asbestos cancer patients live more than 3 months after their mesothelioma recurs. But a clinical trial in France found that 50% of their subjects loved more than three months when treated with Opdivo and Yervoy.
What Are the Benefits of Immunotherapy?
Immunotherapy is one of the hottest topics in mesothelioma research. It is considered by many experts to be the future of treating many types of mesothelioma cancer. The biggest benefit of immunotherapy is that it can keep cancer under control, but there are other benefits:
- Immunotherapy harnesses the natural processes of the immune system to fight cancer.
- Immunotherapy has a targeted approach that kills only cancer cells. One of the problems with chemotherapy is that it kills healthy cells, too.
- There are fewer side effects with chemotherapy, and they are more manageable compared to radiation and chemotherapy.
Immunotherapy Types for Mesothelioma
There have been several types of immunotherapy tested on asbestos cancer over the last 40 years. Recent breakthroughs in clinical trials, such as the development of Keytruda and several immune checkpoint inhibitors, have made immunotherapy a better treatment choice for mesothelioma.
Immune checkpoint inhibitors are drugs that prevent cancer cells from hiding from our immune system. Checkpoint inhibitors are comprised of antibodies that uncover cancer cells and let the immune system recognize them and attempt to destroy them. Checkpoint inhibitors for mesothelioma hone in on checkpoints such as CTLA-4 and PD-1.
The most promising checkpoint inhibitors for asbestos cancer research include Keytruda, Opdivo, and Yervoy. Another hopeful checkpoint inhibitor is called SS1P. It controlled aggressive mesothelioma tumors in some patients but not enough to warrant further investigation.
There is clinical research being done in Hawaii to develop a vaccine that would prevent mesothelioma. Clinical trials have looked at some therapeutic vaccines for mesothelioma. Two vaccines, CRS-207, a listeria-based vaccine, and galinpepimut-S have shown the most potential.
A 2016 clinical study showed that a mixture of chemotherapy and CRS-207 was effective in controlling tumor growth more than chemotherapy by itself.
Also, at the end of 2017, a phase 2 clinical study was being done to study the safety and effectiveness of CRS-207 in combination with Keytruda. But the study ended unsuccessfully.
There was a phase 2 clinical trial of the WT1 vaccine that showed longer survival and better tumor control among patients who got the vaccine versus those who received the placebo. In 2016, the FDA gave the Fast Track designation to the WT1 vaccine. This made it closer to becoming the first FDA-approved, second-line treatment for pleural mesothelioma.
Monoclonal antibody therapy or MaB is the most common type of cancer immunotherapy. But it is not the most common one used for mesothelioma. It is thought of as a targeted therapy because it focuses on a single site in the cancer cell – either the antigen on the cell surface or a protein within the cell.
Tremelimumab is a monoclonal antibody and also an immune checkpoint inhibitor that is being studied for mesothelioma. Clinical tests are studying the drug on mesothelioma patients and the results have been mixed.
Amatuximab is another monoclonal antibody that was a phase 2 clinical trial for mesothelioma patients. However, not enough patients responded favorably to warrant further study. Overall survival with this treatment was 14.8 months, with the average survival for the disease one year.
Do You Have Mesothelioma Cancer?
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