Since mesothelioma is often difficult to treat, scientists and researchers look to combination treatments and therapies to improve chances of patients’ survival. There is no “one” treatment that is used across the board in treating mesothelioma, because patients react differently, whether it is to chemotherapy, radiation therapy, immunotherapy, or surgery. A research team from MD Anderson Center in Texas carefully selected mesothelioma patients to be a part of study and for nearly a decade, trimodality therapy was explored.
Trimodality therapy is a combination of surgery, chemotherapy, and radiation, used in succession to fully combat and increase survival of rare and aggressive cancers such as mesothelioma. This latest study, published by the Journal of Clinical Oncology confirmed what scientists and researchers had already predicted: that with trimodality therapy, patients suffering from mesothelioma have longer survival rates.
For 10 years, scientist and researchers collected data from 6,645 pleural mesothelioma patients – 850 received surgery, 988 received surgery and then chemotherapy, and 274 had surgery, chemotherapy, and radiation. The most positive outcome were in those who had the trimodality therapy, with survival improved when compared to just surgery alone. Those who had the most common subtype of pleural mesothelioma, epithelioid, saw the best results – survival improved from 14.5 months to 23.4 months.While trimodality therapy may seem intense, mesothelioma’s aggressive nature makes combination therapies almost a necessity in order to have potentially positive results.
While scientists and researchers are and have been studying the effects of trimodality treatment, they are also studying immunotherapy treatments for mesothelioma. Standard chemotherapy treatments are often not effective on mesothelioma since the cancer is typically in the advanced stages by the time it is detected. Chemotherapy can weaken healthy cells and tissue, further damaging the immune system and rendering the patient too fragile to fight off common infections, let alone mesothelioma. With immunotherapy, treatments are designed to strengthen and repair the body’s own immune system so the body can better fight off infections and diseases in a more natural way. The US Food and Drug Administration recently approved a new immunotherapy treatment called Imfinzi (durvalumab), granting it the Breakthrough Therapy Designation. By giving it this designation, drug development is expedited in hopes to make it available to the public as soon as possible.
Backed by AstraZeneca and MedImmune, Imfinzi targets those suffering from unresectable Non Small Cell Lung Cancer and have not had any disease progression following a combination of chemotherapy and radiation therapy. Once disease progression ceases in mesothelioma patients, not much can be done other than to wait. Imfinzi could help prevent cancer from spreading and could be given to patients who are in this waiting period. A Phase II clinical trial is currently underway combining Imfinzi with first line chemotherapy treatments cisplatin and pemetrexed.
“IMFINZI™ (durvalumab) granted Breakthrough Therapy Designation by US FDA for patients with locally advanced unresectable non-small cell lung cancer” AstraZeneca (July 31, 2017). [Link]
Nelson, DB, et al, “Long-Term Survival Outcomes of Cancer-Directed Surgery for Malignant Pleural Mesothelioma: Propensity Score Matching Analysis,” Journal of Clinical Oncology (August 17, 2017). [Link]