There is no question that mesothelioma is currently an incurable disease. Remission can happen in certain cases, but there is still no outright mesothelioma cure. One of the major obstacles facing mesothelioma cure research is the fact that the disease is normally caught in its later stages. It is, therefore, much harder to treat and test different kinds of therapies.
Despite this grim outlook, mesothelioma research carries on. New information is being discovered at any given moment, allowing doctors, scientists, and medical researchers to make better and more thorough recommendations for treatment.
Mesothelioma research is generally focused on finding the most effective treatment options. It also seeks to identify exactly how the disease operates in its various forms.
Currently, the three most commonly-used mesothelioma treatments are surgery, radiation therapy, and chemotherapy. All three of them combined provide for better prognoses for most patients.
But, how did researchers get to the point where they recognized the value of all three of these options?
How Mesothelioma Research Has Progressed
In the early 20th century, a link between asbestos exposure and various respiratory and pulmonary issues wasn’t established, but there was certainly suspicion. Autopsies performed on asbestos miners often showed a cavalcade of asbestos fibers embedded in the lining of the lungs. Clearly, there was something amiss with asbestos.
The term “mesothelioma” was first used in 1920 to describe the disease we know today. Even at that time, the link between asbestos and mesothelioma hadn’t been officially identified. More research in the 1930s and 1940s established a tenuous link between the two.
Also in the 1940s, major surgeries that often involved the removal of a lung started being implemented for mesothelioma sufferers. By our standards, these surgeries were rather primitive and didn’t always provide the best outlook for the patients involved.
In the 1960s, the link between asbestos and mesothelioma was proven beyond a shadow of a doubt. Countries across the globe began curtailing their usage of the substance. In the United States, the Occupational Safety and Hazards Administration began regulating the production of asbestos in 1971.
Despite the reduction in asbestos in many capacities, the incidence of the disease has remained relatively steady over the last few decades. This is largely due to the fact that mesothelioma has a long latency period. It could feasibly take up to 50 years for symptoms to start appearing after a patient’s first exposure to asbestos.
In the meantime, surgical procedures improved greatly from the 1970s until now. Better equipment allowed for more precision and less invasiveness, increasing the efficacy of surgery and improving lifespans.
By the 2000s, chemotherapy and radiation therapy had started entering the fold as companion treatment options for surgery. This, of course, improved life expectancy even more for many patients.
Pemetrexed, a breakthrough chemotherapy drug, was approved for use in treating pleural mesothelioma by the U.S. Food and Drug Administration (FDA) in 2004. In many studies, Pemetrexed together with cisplatin has proven to be the most effective chemotherapy combination for treating mesothelioma.
Almost 15 years later and no other chemotherapy drugs have officially been FDA approved for specific use with mesothelioma. But, clinical trials are always making strides in finding that next breakthrough drug.
Clinical trials are also the most important methods for accumulating mesothelioma research that there is.
Research in Mesothelioma Clinical Trials
Most of the salient mesothelioma research takes place during clinical trials. A clinical trial is a way for researchers to identify trends across a large swath of people. The studies involve the administration of one or more treatments to a cross-section of mesothelioma patients that have similar qualities. Not everyone is eligible for every clinical trial.
For the most part, researchers will look at:
- Overall health of the patients
- Their age
- Their gender
- Whether the patient has undergone any previous mesothelioma treatment
- Type of mesothelioma
- Stage of mesothelioma (how far the disease has progressed)
Most clinical trials look for patients whose disease has not progressed past stage 2. After stage 2, mesothelioma begins to metastasize and invade other parts of the body. Treatment options at that point are usually palliative (i.e., designed specifically to improve comfort and quality of life). Patients who are otherwise healthy and have stage 1 or 2 mesothelioma are the best candidates because researchers can monitor disease progress more acutely.
Clinical trials are conducted in phases. These include:
Usually designed to identify the safety of the treatment in question. Generally, up to 50 participants can enroll.
Designed to see how the treatment affects a disease or collection of ailments. Between 200 and 300 people can enroll in most cases.
Designed to compare treatment with already existent but similar treatment after safety and efficacy have been confirmed. As many as 3,000 can join these trials.
Usually conducted after the treatment has been approved by the Food and Drug Administration (FDA) to investigate other avenues like side effects or proper dosages.
The risks involved in clinical trials reduce as the treatment goes through each phase. In Phase I, treatments are likely to be untested and possibly detrimental to those involved. That is why only around 50 or fewer people are allowed to enroll in those studies.
Phases III and IV are generally considered safe options because the treatment in question has been shown to be safe and effective at treating the requisite disease. High-quality care is also often offered to patients who undergo clinical trials because researchers are obviously hoping for the best results.
Sponsors of clinical trials often include:
- Pharmaceutical companies
Obviously, pharmaceutical companies have a financial incentive to produce drugs that are effective and can go to market more quickly. The FDA also requires pharmaceutical companies to conduct clinical trials. In any event, they often put a lot of money into their trials to ensure the best results.
Universities also provide high-quality care with an emphasis on collecting data throughout the trial. University researchers want to get everything right to identify all the ways in which a treatment works best. These clinical trials are usually funded by grants from the government or through other means.
Governments often provide their own governmental agencies with grants to study cancer and other diseases of all types. The United States has the National Cancer Institute, which routinely receives funding for clinical trials of all types. The National Institute of Health also keeps a list of every ongoing and former clinical trial. It’s a great way to find out if you qualify for any mesothelioma clinical trials.
New Treatments with Mesothelioma Research
Research never stops, and new treatment methods are always being developed and tested. One of the more recent treatments for peritoneal mesothelioma (found in the lining of the abdominal cavity) is known as hyperthermic (heated) intraperitoneal chemotherapy (HIPEC). HIPEC involves heated chemotherapy drugs being inserted at tumor locations and throughout the abdomen during major open surgery (usually cytoreductive surgery).
It has demonstrated great effectiveness at improving survival rates for peritoneal mesothelioma patients. In fact, the 5-year survival rate for that type of mesothelioma is now at 52%. This is obviously all thanks to mesothelioma cure research.
Many other treatments, however, fall outside of the standard multimodal therapy of surgery, chemotherapy, and radiation therapy. Many emerging treatments are currently undergoing clinical trials to test their effectiveness at fighting mesothelioma. While the research is still out on many of them, some have shown promise.
- Immunotherapy – a class of medications designed to invoke an immune response against cancer cells
- Gene therapy – the replacement or reprogramming of genes in cancer cells
- Epigenetic therapy – medications and other treatments that produce correct epigenetic responses in cell DNA
- Virotherapy – deactivated viruses used to kill cancer cells
- p53 gene therapy – a type of gene therapy designed to restore normal function to the tumor-suppressing p53 gene in cells
- Photodynamic therapy – the use of light waves to shrink tumors and kill cancer cells
- Cryotherapy – the use of extremely cold temperatures applied to tumor or incision sites
All of these treatments are receiving a great deal of research because any one of them could turn out to be a huge breakthrough in treating mesothelioma. While most of these treatments are only available in clinical trials, certain immunotherapy drugs have already been applied to chemotherapy regimens in standard hospital use.
The Importance of Early Detection
In addition to a wide variety of treatment options, researchers have also been looking toward early detection of the disease. Mesothelioma rarely gets caught early, with only about 20% of patients being diagnosed with stage 1 or 2 of the disease. It is much harder to treat patients when the disease has spread to multiple other locations throughout the body.
In order to combat this, doctors are looking at the efficacy of blood tests and biomarkers (substances in the bloodstream that can indicate disease at high levels). If a biomarker could identify the incidence of mesothelioma accurately, early detection would be more feasible.
Some biomarker tests include:
- Mesomark (testing for soluble mesothelin-related proteins or SMRPs)
SMRPs, osteopontin, N-ERC/mesothelin, and fibulin-3 are all different types of glycoproteins. Mesomark is the only biomarker test (or assay) that has been approved by the FDA for identifying the incidence of mesothelioma. Still, its results are inconclusive, and it can only suggest that mesothelioma may be present. The same applies to all the other glycoproteins.
A new biomarker substance, miR-625-3p, is a type of microRNA that increases its amount in the bloodstream when mesothelioma is present in the body. More studies are needed to confirm this association, but it is certainly a promising start.
Mesothelioma research is always at the cutting edge of medical technology and innovation. As time passes, more and more information will be made available about the disease making it much easier to diagnose and treat.