What's New in Malignant Mesothelioma Research and Treatment?

SOURCE: American Cancer Society – March, 2007

Causes and Prevention Much of the research on mesothelioma has focused on learning exactly how asbestos changes mesothelial cells and their DNA to cause these cancers. Understanding how these fibers produce cancer might help us develop ways to prevent those changes.

The risk of asbestos in developing mesothelioma is a definite public health concern. We are continuously learning more about which fibers can produce cancer, how they cause these cancers, and what levels of exposure can be considered safe. Now that we know about the dangers of asbestos, we can limit or stop exposure in homes, public buildings, and the workplace. Unfortunately, regulations protecting workers from asbestos exposure are much less stringent in some countries and nonexistent in others. Research is also underway to clarify the role (if any) of SV40, a virus that has been linked to mesothelioma in some studies.

New Drugs Because chemotherapy drugs have not been very effective against advanced mesothelioma, several new approaches to cancer treatment are now being studied. These include anti-angiogenesis drugs (which kill cancers by stopping their blood supply) such as Bevacizumab (Avastin) and anti-growth factor drugs (which interfere with substances some cancer cells produce to stimulate their own growth) such as Erlotinib (Tarceva).

Multimodality Therapy The roles of surgery, radiation therapy, and chemotherapy in the treatment of mesothelioma are highly debated. Treatments that use some combinations of surgery, radiation therapy, and chemotherapy, called multimodality therapy, are now being studied and may provide the most promising option for some patients. New chemotherapy drugs are currently being tested in clinical trials, together with other types of treatment. Ranpirnase (Onconase) is an enzyme that breaks down RNA and in preliminary studies has helped some patients with mesothelioma to love longer. Larger clinical trials are currently in progress. Another new drug being tested in mesothelioma clinical trials is suberoylanilide hydroxamic acid (vorinostat, [SAHA]), which may reduce growth of mesothelioma cells by inhibiting an enzyme that controls certain proteins called histones, which regulate DNA.

Gene Therapy A new approach to cancer therapy being tested on mesothelioma is gene therapy. One of these approaches to treating mesothelioma uses special viruses that have been modified in the laboratory. The modified virus is injected into the pleural space and infects the mesothelioma cells. When this infection occurs, the virus injects a gene into the mesothelioma for interferon-beta, an immune system hormone (cytokine) that may help activate immune system cells to attack the cancer.

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