Immune system cells may be some of the best predictors of mesothelioma outcomes, according to a group of British scientists.
A new article in the British Journal of Cancer has found a close association between outcomes in people with different subtypes of malignant mesothelioma and the levels of different types of immune system cells in their bodies.
Measuring Immune Response
To create the experiment, researchers with the University of Southampton in the UK devised a series of tests based on 302 tissue samples from people with advanced malignant mesothelioma.
The samples were examined for markers of adaptive immune response including T-cells and B-cells as well as markers of innate immunity including neutrophils, natural killer cells and macrophages.
These cells all play slightly different roles in responding to perceived threats in the body, including malignant mesothelioma and other cancers.
Immune Profile and Survival
According to the study, mesothelioma patients with the epithelioid subtype had better outcomes when their tumor samples tested high for a certain type of T-cell (CD4+) and B-cell (CD20+) and low in another type of T-cell (FOXP3+), macrophages, and neutrophils.
High CD4+ and CD20+ counts and a low neutrophil count were also helpful in predicting prognosis in the same group.
Only FOXP3+ counts were found to be independently associated with mesothelioma survival in both the epithelioid subgroup and in people with non-epithelioid mesothelioma.
“Our data demonstrate for the first time, in predominately advanced disease, the association of key markers of adaptive and innate immunity with survival and the differential effect of histology [subtype],” writes Serena Chee, part of the medical faculty at the University of Southampton.
Applying Information on Immunity
The next step is for researchers to learn how to best apply this information in individual cases of malignant mesothelioma.
Malignant mesothelioma, which usually occurs in the pleural form on the membrane around the lungs, or the peritoneal form on the membrane around the abdomen, is extremely rare and difficult to treat. Among the biggest challenges is determining exactly which combination of therapies is likely to produce the best outcome for each mesothelioma patient.
Immunotherapies, cancer drugs designed to alter the immune system, are emerging as one of the most hopeful methods of treating – and perhaps even curing – malignant mesothelioma and other cancers. A number of immunotherapy drug trials for mesothelioma are currently ongoing.
The University of Southampton researchers say they hope that a better understanding of the “Immunological drivers” behind different mesothelioma subtypes will help clinicians in determining mesothelioma prognosis and planning treatment.
Chee, SJ, “Evaluating the effect of immune cells on the outcomes of patients with mesothelioma”, August 17, 2017, British Journal of Cancer, Epub ahead of print