Living with malignant mesothelioma can be an emotional roller coaster. On one hand, the prognosis for mesothelioma patients remains relatively poor, in spite of intense research going on around the globe.
On the other hand, new studies released within the past year indicate that 2016 could be the most hopeful year yet for mesothelioma sufferers and their families.
Potential New Mesothelioma Drug
While Alimta (pemetrexed) remains the only medication that is FDA-approved specifically for pleural mesothelioma treatment, other new drugs are showing encouraging results.
One of those is the monoclonal antibody Keytruda (pembrolizumab) which is designed to block a cell surface protein called PD-1. This protein is believed to be expressed by up to 40 percent of mesothelioma tumors.
In a recent trial conducted in Canada, 76 percent of mesothelioma patients responded to treatment with Keytruda, a figure the researchers called “unprecedented”.
Keytruda was approved in late 2015 as a second-line treatment for relapsed non-small cell lung cancer.
Another Approach to Mesothelioma Immunotherapy
Another immunotherapy drug gaining momentum in 2015 as a potential new mesothelioma treatment is tremelimumab.
Tremelimumab targets a different immune system “checkpoint” called cytotoxic T-lymphocyte antigen-4 (CTLA-4).
This CTLA-4 inhibitor, made by AstraZeneca, was granted Orphan Drug status by the FDA for its potential to extend mesothelioma survival – particularly in patients who fail to respond to standard chemotherapy.
New Delivery Method for Common Mesothelioma Drug
Conventional chemotherapy for mesothelioma also got a boost in 2015.
Several studies in the past year have supported the idea that the mesothelioma drug Alimta, the most common chemotherapy drug used to treat the asbestos cancer, is more effective if it is delivered with a fat-based coating around the molecules.
Liposomal pemetrexed encapsulates each molecule of Alimta in a bubble-like liposome, allowing more of the drug to enter mesothelioma tumors with less damage to healthy cells and fewer toxic side effects.
New Thoughts on Mesothelioma Surgery
2015 also saw the release of several studies supporting the idea that mesothelioma patients who have lung-sparing surgery tend to have been survival results over time than those who have more radical surgery.
The latest mesothelioma surgery study included 362 European mesothelioma patients and found no survival differences between patients who had the two types of surgery – even though the patients who had the more conservative approach tended to be older and sicker than those who had the radical surgery.
Raja Flores, MD, a top mesothelioma researcher with Mount Sinai Medical System in New York, also came out in favor of more conservative mesothelioma surgery to optimize mesothelioma survival.
Mesothelioma Diagnosis with Biomarkers
Another advance in 2015 involved the release of a mesothelioma blood test that researchers say will improve diagnosis.
A potential new blood test still being studied combines a test for soluble mesothelin-related proteins (SMRPs) with two additional biomarkers for a more accurate – and potentially earlier – mesothelioma diagnosis.
Sharkey, AJ, et al “The effects of an intentional transition from extrapleural pneumonectomy to extended pleurectomy/decortication”, December 3, 2015, European Journal of Cardiothoracic Surgery, Epub ahead of print
Ando, H, et al, “Advanced therapeutic approach for the treatment of malignant pleural mesothelioma via the intrapleural administration of liposomal pemetrexed”, October 14, 2015, Journal of Controlled Release, Epub ahead of print
“FDA approves Keytruda for advanced non-small cell lung cancer”, October 2, 2015, FDA website
Santarelli, L, et al, “Combined circulating epigenetic markers to improve mesothelin performance in the diagnosis of malignant mesothelioma”, September 25, 2015, Lung Cancer, Epub ahead of print