The Search for a Malignant Mesothelioma Cure: Emerging Treatment Options and Mesothelioma Research

Search for a Mesothelioma Cure: Is This Cancer Curable?

There is no known cure for mesothelioma, which is a rare and fast-spreading cancer caused by exposure to asbestos. The cancer develops primarily in the lining of the lungs, abdominal cavity and heart. Tumors spread quickly to vital organs such as the lungs, kidneys, heart, pancreas, and large and small intestines.

Current treatment options for mesothelioma are surgery, immunotherapy, chemotherapy and radiation. Some of these are approved by the U.S. Food and Drug Administration, while others are used as part of clinical trials or based on an expert doctor’s prognosis and surgical abilities.

Researchers continue to examine ways to improve these treatment options, including how to use technology to improve surgery and combinations that make the therapies more effective.

Scientists also are exploring other treatment options – emerging methods that enhance the immune system, use lab-generated genes to stop tumors from spreading, and use engineered viruses to infect and kill cancer cells from within.

Top New Mesothelioma Treatment Options

Surgery, immunotherapy, chemotherapy, and radiation therapy are the foundation of mesothelioma treatment. However, advancements in research have led to promising new therapies.

Immunotherapy is an emerging treatment for mesothelioma. Researchers are focused on developing and improving immune checkpoint inhibitors, which work by strengthening the response from the body’s immune system.

Other emerging treatments for mesothelioma are:

• Virotherapy/Oncolytic viruses – Using viruses to selectively attack and destroy cancer cells
• Tumor treating fields – A non-invasive therapy that disrupts cancer cell division using electric fields
• Photodynamic therapy – A light-based treatment that activates drugs to kill cancer cells
• Gene therapy – A cutting-edge approach that modifies genes to fight or prevent cancer
• CAR T-cell therapy – A strategy of engineering immune system cells to make them better at fighting cancer

Research into these emerging therapies, along with ongoing clinical trials to test the therapies, continue to drive progress in the search for a mesothelioma cure.

Mesothelioma Immunotherapy

Immunotherapy is a groundbreaking approach to mesothelioma treatment that enhances the body’s natural defenses against cancer. There are two main types of immunotherapy for mesothelioma:

• Active Immunotherapy – Uses medications to stimulate the immune system to recognize and attack cancer cells; an example is checkpoint inhibitors
• Passive Immunotherapy – Involves laboratory-engineered proteins that supplement or enhance the body’s immune response; examples are monoclonal antibodies and CAR T-cell therapy

Currently, no other immunotherapy drugs have received FDA approval for mesothelioma treatment, but ongoing clinical trials continue to explore new possibilities.

CAR T-cell Therapy for Mesothelioma

CAR T-cell therapy is an emerging cancer treatment that engineers a patient’s immune system to more effectively defend the body against cancer. It is a combination of gene therapy and immunotherapy, often called “cell and gene therapy.”

The immune system contains cells, called T cells, that look for diseases such as viruses and cancer. Their job is to attack these unwanted invaders. However, cancer contains certain characteristics to hide from T cells.

Doctors draw the patient’s blood and isolate T cells, which are sent to a lab to be reprogrammed. The cells are then multiplied by the millions and returned to the patient’s bloodstream, where they begin searching for cancer cells.

CAR T cells for mesothelioma are engineered to look for the protein mesothelin. This protein is expressed on the surface of mesothelioma tumor cells.

CAR T-cell therapy is approved for specific types of the blood cancers leukemia, lymphoma and multiple myeloma. Some patients, including children, with resistant blood cancers and poor prognosis have been deemed cured of their cancer thanks to CAR T-cell therapy.

This emerging treatment is in clinical trial testing for mesothelioma.

Mesothelioma Oncolytic Viruses (Virotherapy)

Virotherapy, or oncolytic virus therapy, is an innovative approach to mesothelioma treatment. This therapy uses genetically modified viruses to target and destroy cancer cells while leaving healthy cells unharmed. This concept dates back more than 100 years when doctors noticed some cancer patients’ tumors shrink after viral infections.

Today, virotherapy for mesothelioma falls into three main categories:

• Oncolytic viruses attack cancer cells by infecting and breaking them up internally.
• Viral immunotherapy infects tumors to stimulate a response from the patient’s immune system.
• Viral vectors transport cancer-fighting therapies into cells.

A promising virotherapy treatment for mesothelioma is ONCOS-102. This oncolytic virus not only destroys cancer cells but stimulates the immune system.

Recognizing its potential, the U.S. Food and Drug Administration (FDA) granted ONCOS-102 fast-track designation, ensuring it receives priority review in the approval process. This designation highlights the growing interest in virotherapy as a potentially life-extending treatment for mesothelioma patients.

Tumor Treating Fields for Mesothelioma

Tumor treating fields are an innovative, non-invasive cancer therapy. The FDA approved a tumor treating fields device for unresectable pleural mesothelioma to be used with chemotherapy.

The approved therapy, called Optune Lua, is a wearable device that emits low-intensity electric fields that penetrate the body, disrupting the division of cancer cells and ultimately causing them to die. Patients wear the device for most of the day, even while sleeping. Unlike traditional treatments, tumor treating fields specifically target rapidly dividing cells while sparing healthy tissues.

Mesothelioma Photodynamic Therapy

Photodynamic therapy is an advanced treatment that uses light-sensitive drugs, known as photosensitizers, to target and destroy mesothelioma cells. Once administered intravenously, these drugs accumulate in cancer cells. When exposed to a specific wavelength of light, the photosensitizers activate, releasing oxygen that kills nearby tumor cells.

Beyond directly destroying cancer cells, photodynamic therapy also limits tumor growth by preventing the formation of new blood vessels. Without an adequate blood supply, tumors are deprived of essential nutrients, slowing their progression.

This therapy not only kills mesothelioma cells but also weakens tumors, making them more responsive to chemotherapy and radiation therapy. Photodynamic therapy is generally well-tolerated, but some patients may experience side effects such as skin rashes and heightened sensitivity to light.

Mesothelioma Gene Therapy

Mesothelioma gene therapy is a cancer treatment that adds, removes, or alters genes in the patient’s body to help it fight cancer. Some lab-generated genes can help fight cancer, while others block cancerous genes and weaken cancer cells.

Doctors deliver gene therapy drugs through viral vectors or bacteria. As the viral vectors deliver healthy DNA to the area of the body where cancer exists, dysfunctional genes become functional or genes help the body produce cancer-fighting proteins (like “interferon alpha-2b protein”). These proteins inspire a reaction from the immune system and can keep the cancer “at bay”, preventing it from spreading and weakening the patient.

Dr. Daniel Sterman, of NYU Langone Health, is an expert in cancer gene therapy. He believes in the power of gene therapy for mesothelioma. Dr. Sterman hopes doctors can take mesothelioma “from a death sentence to a chronic disease that a patient can live with for years.”

SMART (Surgery for Mesothelioma After Radiation Therapy)

SMART for mesothelioma is an innovative multimodal treatment protocol available at select cancer centers. SMART is an acronym for “surgery for mesothelioma after radiation therapy.” Unlike traditional approaches that administer radiation therapy after surgery, SMART reverses the sequence, delivering high-dose radiation days before surgery.

This multimodal therapy is specifically designed for patients with malignant pleural mesothelioma and is not intended for peritoneal mesothelioma. The goal of pre-surgical radiation is to shrink tumors and eliminate microscopic cancer cells, making surgery more effective.

The Princess Margaret Cancer Centre in Toronto, Canada, pioneered the SMART approach. Michigan Medicine later became the first U.S. institution to adopt this protocol.

Clinical Trials for Mesothelioma and Future Emerging Treatments

Clinical trials play a vital role in testing new and experimental mesothelioma treatments, including immunotherapy, gene therapy, and virotherapy. These studies give patients access to groundbreaking therapies that are often unavailable any other way.

To qualify for a clinical trial, patients must meet specific eligibility criteria, such as age, gender, overall health status, mesothelioma type and mesothelioma stage. These requirements ensure the trial is conducted safely and effectively while identifying the patients most likely to benefit from the study.

Our patient advocates can provide additional information about mesothelioma clinical trials and where they are being conducted. We can help you find a trial that fits your needs and expands your treatment opportunities. Clinical trials are the best hope of finding a mesothelioma cure, and you can play a part in finding the answer to defeating this cancer.

How to Help Find a Mesothelioma Cure

Whether you are diagnosed with mesothelioma, a caregiver of someone with mesothelioma, the loved one of someone who died of this cancer, or simply an activist hoping to help everyone affected by the disease, you can help find a cure for mesothelioma.

By getting involved, you can help scientists research new ways to use surgery, chemotherapy, immunotherapy and radiation. Your participation in the search for a mesothelioma cure can also help experts uncover new treatment options, progress emerging therapies in testing, and bring more hope to patients in need.

Support Research

Whether you have mesothelioma or are a caregiver or activist, you can donate to nonprofit organizations affiliated with top cancer centers, or nonprofits that provide grants to support research.

The American Cancer Society, American Association for Cancer Research, and Cancer Research Institute all are working to find cures for cancer. The Mesothelioma Applied Research Foundation is a nonprofit organization specifically supporting research for mesothelioma.

Participate in Clinical Trials

If you’re diagnosed with mesothelioma, participating in a clinical trial is the best way to help advance research for this rare cancer. Clinical trials test emerging therapies or new combinations of proven treatment options. Participating in a study is a way to not only access new and emerging treatments, it also is a way to provide scientists with more information on how to beat this rare cancer – hopefully providing a better outlook for future mesothelioma patients.

Raise Awareness of Mesothelioma

Increasing awareness of mesothelioma – including the signs and symptoms – helps with early detection and diagnosis. The earlier the disease is found, the more likely people can receive surgery and other aggressive treatment options.

Advocate to Your Government Leaders

Funding from the government supports crucial cancer research, especially through grants from the National Institutes of Health and National Cancer Institute. Reaching out to your government leaders is another way to advocate for mesothelioma research. Government leaders hearing from people affected by cancers like mesothelioma is imperative to the objective of finding a cure.