Targeted therapies may be the future of mesothelioma treatment. That word comes from a team of some of the world’s top mesothelioma researchers at the University of Hawaii and New York University. The group has just published a review detailing what is known about how mesothelioma develops – also called “pathogenesis” – and how that growing knowledge may help scientists develop more effective treatments.
“Novel treatments are needed, as current treatment modalities may improve the quality of life, but have shown modest effects in improving overall survival,” writes Dr. Michele Carbone, corresponding author on the review and a top name in mesothelioma research. Dr. Harvey Pass, chief of the division of thoracic surgery at New York University’s Langone Medical Center and another notable mesothelioma expert, is also an author on the report.
There are several different ways that new targeted therapies for mesothelioma may help to combat the asbestos cancer. One way is by manipulating cellular processes at the molecular level. The drug bevacizumab is a new agent that inhibits vascular endothelial growth factor (VEGF), a signaling protein that helps gives rise to the vascular structure needed to support growing tumors. Without VEGF, tumors may shrink or die.
Another targeted approach to mesothelioma treatment is immunotherapy. This approach uses agents such as monoclonal antibodies, immunotoxins, and viruses to effectively “jump start” the immune system into attacking mesothelioma cells. Many cancers, including mesothelioma, produce substances which allow them to “hide” from the immune system. Immunotherapy is designed to help the immune system work around this protective mechanism.
A third type of targeted therapy made possible by an improved understanding of the pathogenesis of mesothelioma is the inhibition of asbestos-induced inflammation. The University of Hawaii researchers were some of the first to draw a link between chronic inflammation in the lung lining and the development of mesothelioma. Now, emerging research has suggested that aspirin, which is an anti-inflammatory drug, may decrease or delay the onset of mesothelioma.
While mesothelioma remains a devastating disease, with these and other new targeted therapies on the horizon, there is greater hope than ever for extended survival and improved quality of life.
Bononi, A et al, “Latest developments in our understanding of the pathogenesis of mesothelioma and the design of targeted therapies”, Expert Review of Respiratory medicine, August 26, 2015, Epub ahead of print