The average survival rate for mesothelioma after diagnosis is less than one year; however, certain individuals will survive longer than others, but the reason as to why this is, is largely unknown. The latest study to be published in Histopathology investigates what it is in the body that determines a higher survival rate in some, but not others. Scientists and researchers are hopeful that the results of this study could guide them in to treatment options that have not yet been explored that will increase survival rates overall.
Determining Survival Traits
Scientists and researchers decided to investigate the role of a cyclin-dependent kinase inhibitor known as p16 because evidence is shown that it slows down the cell cycle. P16 found encoded on the CDKN2A gene and acts a tumor suppressor. The method for this testing was immunohistochemistry (IHC), which is type of lab test that uses antibodies to test for certain markers by using a tissue sample. Using pleural mesothelioma that was biopsied from 1991 to 2014, p16 IHC was performed. Results showed that p16 was negative in 74% of the cases, and this information directly correlated to poor overall survival (7.6 months v. 13.6 months). However, other factors did indicate that with the loss of BAP1 expressions and epithelioid morphology, survival was indeed prolonged.The study concluded that p16 is an independent prognostic biomarker for pleural mesothelioma and can indicate a prolonged survival if the patient exhibits that kinase inhibitor. To have an even more accurate identification of who had better chances for prolonged survival, p16 IHC can be used in combination with BAP1 IHC and morphological subtyping.
Prolonging Survival Altogether
Treating mesothelioma has proven to be difficult and without a verified second line of treatment, patients are initially given cisplatin or pemetrexed chemotherapy . However, over time, immunotherapy treatments are becoming a more viable option and improving survival time significantly. By working to repair and strengthen the body’s own immune system, immunotherapy treatments are preferred for those in the later stages of the disease because very few side effects are associated with it. Immunotherapy is a targeted therapy that only attacks the mesothelioma cells, not the healthy cells, unlike chemotherapy. This allows patients to be able to remain strong and fight the cancer with a full body of strength. Immunotherapy can also slow down metastasis, which helps control the pain, and keeps the patient healthier as well.
Immunotherapy treatments at the moment are currently available only through clinical trials, but the Phase II trial of immunotherapy treatment pembrolizumab have scientists and researchers hopeful that a certified second line treatment is in sight. Pembrolizumab blocks the protein that is responsible for cancer cells to survive and multiply and allows the immune system to do its job – destroy the cancer.
Source:
A Chou, et.al., “The epithelioid, BAP1-negative and p16-positive phenotype predicts prolonged survival in pleural mesothelioma,” Histopathlogy (Septemeber 2017). [Link]
