Bevacizumab: An Immune Therapy in Mesothelioma Treatment

Bevacizumab, an immune therapy, enhances the immune system to target cancer cells.

Historically, chemotherapy drugs were considered the standard treatment. But, a new study highlights bevacizumab, an immune therapy. It can now be considered in combination with mesothelioma treatments where accessible.

Chemotherapy has been a popular treatment therapy. Cytotoxic chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. It results in a modest improvement in patient survival. But toxicity limits the eligible patient population.

Targeted Chemotherapy Agents

Immunotherapies are now playing a greater role in the treatment of many cancers.

The last decade has presented a paradigm shift. There has been a change in the way we understand the relationship between the immune system and cancer progression. Several targeted agents beyond Bevacizumab, an immune therapy, have shown superior efficacy compared to placebos.

The role of angiogenesis pathway inhibition in mesothelioma remains uncertain. So, the standard of care for the first-line treatment of mesothelioma has remained chemotherapy drugs (e.g., cisplatin/pemetrexed). Yet, bevacizumab can be considered in combination where accessible.

First-Line Combination Treatments

Several mesothelioma trials have shown promising results for immune and cell-based therapies. These studies included assessments of the first-line efficacy of combination ipilimumab/nivolumab treatment.

The first study to assess the efficacy of immunotherapy was published in 2017. Patients received pembrolizumab at 10 mg/kg intravenously every 2 weeks. They continued treatment until disease progression, intolerable toxicity, or study withdrawal. The median survival was 18 months. Two patients completed the protocol with a greatest of 24 months of treatment.

Immune Therapies

New agents have expanded the treatment compendium in the last 20 years. Expanding the expected survival for patients with advanced malignant pleural mesothelioma.

Yet, the loss of immune control is now recognized as a “hallmark” of carcinogenesis. Immune-directed therapies are now playing a greater role in the treatment of mesothelioma. This includes Bevacizumab, an immune therapy.

Immunotherapy in combination with chemotherapy may possibly improve patient outcomes even further. It may also avoid hyper-progression on immune checkpoint inhibitors.

These immune therapies are likely to play a central role in the treatment of mesothelioma going forward.

Shantanu Banerji of the CancerCare Manitoba Research Institute said, “Immune checkpoint inhibitors now pose a viable alternative to cytotoxic chemotherapy in many patients, either in treatment-naïve patients or as a subsequent line of therapy.”

Advances in cellular therapies provide more opportunities to harness the immune system.

The optimal timing and combinations of these therapies are still being defined. Researchers are still working to maximize the benefits of Bevacizumab, an immune therapy. But it is clear this research presents an exciting future in the treatment of this challenging disease.

Sources

Banerji, S.; Meyers, D.E.; Harlos, C.; Dawe, D.E. The Role of Immunotherapy in the Treatment of Malignant Pleural Mesothelioma. Curr. Oncol. 2021, 28, 4542–4551. https://doi.org/10.3390/curroncol28060385