Last modified: October 24 2008.
Mesothelioma & Asbestos Awareness Center
Unfortunately, a diagnosis of mesothelioma has never carried much hope for the victim. Mesothelioma is an aggressive form of cancer that's rarely diagnosed until it's reached an advanced stage. Mesothelioma treatment options have been limited and the prognosis is usually grim.
Nonetheless, because there's been a rise in the disease and more doctors and research scientists are stepping up and taking notice of this dreaded illness, more research pioneers have jumped on the bandwagon in the search for better treatment and ultimately a cure for the disease.
Finding New Treatments
As more and more money begins to be spent on this disease which affects individuals from many countries throughout the world, new treatments are emerging all the time. Research allows doctors and scientists to better understand the design of the disease and researchers are eager to develop both new forms of common treatments as well as totally new treatment procedures. Good research and proper funding allows the opportunity to do both.
As these drugs or procedures are developed, they are tested in clinical trials by people who already have the disease. The success or non-success of the clinical trial will dictate whether or not the drug or procedure will be approved in the U.S. by the Food and Drug Administration (FDA). Once the FDA issues an approval, the new treatment will be available to the general public, not just a hand-selected group of trial patients.
What's New in Research?
Chemotherapy - Chemo has always been the treatment of choice for mesothelioma patients, usually as a palliative measure to relieve symptoms and make the patient more comfortable. Strides in the field of chemotherapy vs. mesothelioma are promising. The most notable new drug is Alimta©. This drug, when combined with another long-used chemo drug called Cisplatin, is the only Food and Drug Administration approved agent designated for specific use in combating malignant pleural mesothelioma.
Another drug currently on the FDA's Fast Track system and awaiting imminent approval is Onconase©. Onconase is a first-in-class drug that has been shown to target cancer cells while sparing normal cells.
Anti-Angiogenesis drugs - As the name indicates, these drugs are designed to prevent angiogenesis, the process by which new blood vessels are formed from pre-existing vessels. Angiogenesis plays a key role in the spreading of tumors, so researchers are searching for ways to halt the process in cancer patients. One anti-angiogenesis drug for mesothelioma treatment is currently being offered. It's called Avastin and it lowers the levels of a protein that prompts angiogenesis, therefore inhibiting cell growth.
Intensity Modulated Radiation Therapy - Unlike standard radiation therapy, this new form of radiation is done in the interest of limiting the amount of radiation hitting the healthy tissue surrounded the area where the tumor is located.
Gene Therapy - Many researchers are taking a close look at gene therapy in regards to its success in treating a number of diseases, including mesothelioma. According to the American Cancer Society, this approach 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.
Becoming Part of a Clinical Trial
Most oncologists (cancer doctors), especially those that specialize in the treatment of mesothelioma, will most likely be aware of the clinical trials that are currently seeking patients who are fighting mesothelioma.
If you are a candidate, you should know that there are basically 4 types of clinical trials.
Treatment trials - these trials test new approaches to cancer treatment, be it a drug, radiation therapy, a multi-modal therapy, or a totally new treatment procedure.
Prevention trials - these trials test approaches to lowering the risk of developing a certain kind of cancer.
Screening trials - such trials test new ways to detect cancer, particularly in its early stages. These are important trials in the field of mesothelioma, which is usually diagnosed in its late stages.
Supportive care trials - these trials test ways to improve comfort and quality of life for cancer patients, often referred to as palliative treatments.
Patients can be involved in various phases of a trial.
Phase I helps determine how a new drug should be given and attempts to measure safe dosage. This phase generally involves only a handful of volunteers.
Phase II trials usually focus on one particular type of cancer and are used to test the safety of the drug and how well it works in combating a particular cancer.
Phase III trials test new drugs or treatments in comparison with the current standard. In a process called randomization, the participant will be assigned to the standard group or the new group. Phase III trials are the largest and may often involve doctors and hospitals throughout the country.
Your doctor can best determine if you are a candidate for any ongoing trials and will take the responsibility of submitting the proper paperwork for consideration. Don't be afraid to ask about new clinical trials or inquire about one of which you may be aware.
References: Antman KH. "Natural History and Epidemiology of Malignant Mesothelioma". Chest. 1993 Apr, Vol. 103(4 Suppl). pp. 373S-376S
American Cancer Society: Detailed Guide. What is Malignant Mesothelioma?.
Rom WN, Travis WD and Brody AR. "Cellular and Molecular Basis of the Asbestos-Related Diseases". American Review of Respiratory Diseases. 1992, Jan, Vol. 145(1). pp. 238-9
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