Several promising drugs are currently in trials to extend the lives of mesothelioma patients. Mesothelioma is caused by tiny asbestos fibers that are inhaled and implanted in the lungs. Diagnosis generally takes many decades for the disease to appear, usually meaning it’s in a late stage before discovery.
Dr. Julie Renee Brahmer, associate professor of oncology and interim director at the Johns Hopkins Kimmel Cancer Center at Bayview states, “Really, treatment since the early 2000s has not changed for mesothelioma.” Currently, the FDA has approved only one drug combination treatment for mesothelioma. Pemetrexed, a chemotherapy drug that blocks the action of a substance in the body that may assist multiplication of cancer cells is combined with cisplatin, another chemotherapy drug that can kill cancer cells. But, as Dr. Brahmer says, “Mesothelioma is such a slow-growing disease that it is insidious, and we need to find better ways to treat people.”
After diagnosis, most mesothelioma patients live only 7 to 17 months and there are only about 3,000 patients diagnosed annually. Because of such a low incidence, drug companies have been slow to develop interest in creating new drugs. The FDA has given research a boost by creating an orphan drug designation that gives makers of drugs for rare diseases extended exclusivity to sell the drugs and tax credits for their development.
Treatments In Clinical Trials
This orphan drug designation was given to AstraZeneca in April for its drug, tremelimumab, created to treat mesothelioma. This drug is part of a large group of treatments under development designed to utilize the body’s own immune system to fight the cancer.
Studies are also assessing gene therapy. This would attempt to add new genes to the mesothelioma cells making them easier to kill.
Dr. Brahmer is involved in a study targeting cancer stem cells and also is testing a vaccine that attacks a protein on mesothemial cancer cells.
Other research is studying the use of specially designed viruses. These could directly infect and kill the cancer cells or cause the patient’s immune system to attack the cancer cells.
Other Treatment Options
In addition to drugs, there are surgical options. However, Dr. Joseph Friedberg, a mesothelioma expert and professor of surgery at the University of Maryland School of Medicine states, “You are almost certainly going to succumb to the cancer at some point. The goal is to try and buy you more time.” Dr. Friedberg, who is also thoracic surgeon-in-chief for the University of Maryland Medical System, also pioneered a lung-sparing surgical technique for mesothelioma and, with felllow researchers, obtained some of the best and most optimistic results reported. Part of the therapy included the use of photodynamic therapy, a light-based treatment that may stimulate the immune system against the cancer. This is under ongoing study.
Of these treatments, many are still in early phases of clinical trials, but the good news is that there is now more attention than ever before in the treatment and eradication of mesothelioma. “For the first time we have more companies than ever interested in this orphan disease,” said Mary Hesdorffer, a nurse practitioner who is executive director of The Meso Foundation, a nonprofit organization dedicated to ending mesothelioma and its suffering.
As Dr. Friedberg said, “We’re not where we need to be, not even close, but there is progress being made all around.”
