Rare and aggressive in nature, mesothelioma is often a fatal cancer mainly due to its lack of response to most treatments. Surgical options have a higher chance of success for those in the early stages of the disease, but since there is a long latency period between asbestos exposure and symptoms of mesothelioma, often times the cancer is in the advanced stages before it is detected – making surgery not a viable option. A current clinical trial to take place in Portland, Oregon, is taking a look at combining chemotherapy and immunotherapy treatments with surgery in hopes to improve overall survival, progression-free survival, and response evaluation criteria in solid tumors (RECIST). These treatments are atezolizumab, pemetrexed disodium (pemetrexed), and cisplatin.
Immunotherapy treatment – Atezolizumab
Immunotherapy treatments are designed to work with the body’s own immune system – repairing and strengthening – so that the body can fight off diseases and infections in a natural way. Often times chemotherapy treatments can be harsh on the healthy cells and tissue and cause the patient become weak while trying to fight off cancer. With immunotherapy treatment, only are the infected cells are targeted, leaving the healthy cells intact. Atezolizumab is a monocloncal antibody immunotherapy treatment designed to attack the protein programmed cell death-ligand 1 (PD-L1), which is a protein that suppresses the immune system. Researchers for this particular clinical trial are hopeful that atezolizumab will interfere with the cancer tumors ability to spread and grow. Giving atezolizumab before surgery can reduce the size of the tumor, making it easier to remove. Alternatively, atezolizumab could also be administered after surgery, in hopes of killing off any remaining cancer cells that are now small enough to be affected. Atezolizumab is already being used in some Non-Small Cell Lung Cancer cases.
Chemotherapy Treatments – Pemetrexed and Cisplatin
Pemetrexed was approved in 2008 by the FDA as a treatment for malignant pleural mesothelioma when used in combination with cisplatin. Its main function is an enzyme inhibitor, which when administered can prevent DNA and RNA formations that allow tumors to grow and spread. In this clinical trial, scientists and researchers are hopeful that if pemetrexed is administered and successful in stopping tumor growth, the tumor may be better able to be removed during surgery.
Cisplatin is a common cancer treatment used in a number of besides mesothelioma and is administered through injecting into the vein. For nearly 40 years cisplatin has been licensed for use and is categorized as one of the most effective and safe medicines for cancer treatment. While it is successful in certain types of cancer, when it comes to mesothelioma, cisplatin is less effective. As mentioned earlier, mesothelioma is difficult to detect early, and often times when it is found, it is in the advanced stages. In this clinical trial, scientists and researchers hope that by giving cisplatin to patients before surgery, tumor cells will either be killed, or suppressed to the point where the cells do not divide and spread.
Are you eligible for this clinical trial? Find out more about eligibility, enrollment, investigators, and location by visiting mesotheliomacenter.org/clinical trials.