An induction therapy is the first in a series of therapeutic measures, which, in the case of mesothelioma, may include chemotherapy, radiation, surgery, immunotherapy or other types of experimental treatments. Because mesothelioma is so treatment-resistant, most patients require a combination of therapies to see results, an approach that clinicians refer to as “multi-modality.”
Dr. Laura Donahoe and her colleagues at Toronto Mesothelioma Research Program recently published their summary of novel induction therapies being test for pleural mesothelioma, including a new protocol that they have developed for radiotherapy prior to mesothelioma surgery. The protocol consists of accelerated hemithoracic (one side of the chest) radiation followed by lung-removing extrapleural pneumonectomy (EPP) surgery.
“The rationale behind this protocol is to maximize both the tumoricidal and immunogenic potential of the radiotherapy while minimizing the radiation toxicity to the ipsilateral lung,” explains Dr. Donahoe in a summary of the research in Seminars in Thoracic and Cardiovascular Surgery. “Our initial trial demonstrated the feasibility of this approach and has shown encouraging results in patients with epithelial histology.”
But the Toronto team is not the not the only research team testing new types of induction therapies for mesothelioma. The article also references ongoing or recently-completed clinical trials of pre-surgical mesothelioma induction therapies using
- Interferon-a to interrupt mesothelioma cell growth
- Measles virus to kill cancer cells and jumpstart anti-tumor immune responses
- Defactinib (a focal adhesion kinase inhibitor) to attack mesothelioma stem cells
- Dasatinib (an oral leukemia drug) to manipulate levels of certain mesothelioma biomarkers
Both the defactinib and the measles virus trials are currently recruiting participants. Interested patients can get more information at ClinicalTrials.gov. Because there is significant disagreement on which mesothelioma therapies are most effective and in which order they should be used, treatment plans are formulated on a case-by-case basis by patients and their clinicians.
Donahoe, L et al, “Novel induction therapies for pleural mesothelioma”, Autumn, 2014, Seminars in Thoracic and Cardiovascular Surgery, pp. 192-200