Asbestos is a dangerous mineral that causes many different cancers including mesothelioma, lung cancer, and colon cancer. In the case of mesothelioma, its sharp, microscopic fibers are first inhaled and then become embedded in the mesothelial tissue surrounding the lungs. Since asbestos is only regulated and not banned in the United States, people can still be exposed to asbestos and develop mesothelioma and other cancers. The long latency period also means that people exposed to the carcinogen decades earlier are now being diagnosed. New treatments for the disease need to be created and explored so people diagnosed in the future can live longer and better lives.
Mesothelioma patients may soon be able to choose between chemotherapy and immunotherapy when being treated for their disease. Patients could see similar results from immunotherapy treatments compared to chemotherapy, so using immunotherapy treatments could be another option for those suffering from mesothelioma. The PROMISE-meso trial found that more studies need to be done to see why some cases of mesothelioma respond well to immunotherapy and some adapt to it, leading to varying results in patients.
The PROMISE-meso trial studied how well the immunotherapy drugs worked in patients when used alongside the checkpoint inhibitor pembrolizumab and standard chemotherapy. The patients that were examined also had their mesothelioma relapse or were in their first line treatment. In the study, four times the patients responded to immunotherapy, but this did not delay the cancer’s progression or improve their overall survival. Some patients benefitted from using the immunotherapy for a long period of time, but not all responded very well. More research needs to be done to figure out which patients will respond to immunotherapy so they can be given the most appropriate treatment. Pembrolizumab is also not any better than chemotherapy, but it helped equally, making it a viable alternative.
The study had 144 patients with advanced pre-treated mesothelioma. They were randomized to pembrolizumab, and were given 200 mg every three weeks or were given standard chemotherapy. At progression, patients were able to cross over to pembrolizumab. The objective response rate was 22 percent in patients treated with pembrolizumab versus six percent treated with chemotherapy.
Results of lung cancer trials need to be applied to current mesothelioma treatments, potentially helping patients in the future. Studies have shown that lung cancer responds to immunotherapy and chemotherapy combined together. Chemotherapy and immunotherapy being combined with other anti-cancer drugs need to be studied further to improve mesothelioma patients’ survival.
Source:
Mesothelioma Trial Suggests Immunotherapy as an Alternative to Chemotherapy ESMO (September 30, 2019). [Link]