Mesothelioma Immunotherapy
It seems like such a simple solution — giving the body’s own immune system the ammunition it needs to fight mesothelioma and other cancers. Although it’s not as simple as it sounds, there is much talk in the mesothelioma community about the great potential for immunotherapy in treating mesothelioma.
Several clinical trials have shown promise in using this type of mesothelioma treatment, and immunotherapy has already been approved by the FDA to treat some types of cancers, such as skin cancer and lung cancer. Although surgery, chemotherapy and radiation are still the primary treatment methods, immunotherapy for mesothelioma may be the next big breakthrough for hopeful patients.
How Does Immunotherapy Work?
Your immune system is a network of white blood cells, organs and tissues that work together to identify and attack dangerous cells and diseases that invade the body. However, mesothelioma cancer cells often go undetected by your immune system, which gives the cells free reign to invade the pleural tissue surrounding your lungs or the peritoneal tissue lining the abdominal cavity. Without interference from your immune system, the mesothelioma cancer cells can multiply, causing tumors.
Immunotherapy, also known as biologic therapy or biotherapy, aims to give your immune system a helping hand in fighting the cancer. As the National Cancer Institute explains, it does this by either:
- Stimulating specific components of the immune system to assist it in attacking the cancer cells.
- Counteracting signals produced by the cancer cells that help them hide from the immune system, allowing the body to recognize the cancer cells and attack them.
It is important to note that as you age, some parts of the immune system begin to slow down, leaving you more vulnerable to disease. Because mesothelioma can develop 15 to 60 years after a person has been exposed to asbestos, many mesothelioma patients are older and therefore their immune systems may not be as equipped to fight the disease. This is one of the reasons the prospect of using immunotherapy for mesothelioma gives patients in the community such hope for the future of this type of treatment.
Why Choose Immunotherapy for Mesothelioma Treatment?
Many mesothelioma patients play an active role in exploring all the treatment options available to them, from traditional treatments to clinical trials to holistic methods. There are several reasons patients may choose to try immunotherapy for mesothelioma treatment, including:
- Immunotherapy is a targeted cancer therapy, meaning it only targets the cancer cells or the cells of the immune system, as opposed to treatments such as traditional chemotherapy that may cause harm to other types of healthy cells in the body.
- When traditional treatments such as surgery, chemotherapy and radiation have been ineffective, an immunotherapy clinical trial may provide another treatment option for patients.
- Although immunotherapy does have side effects, it is considered a more gentle treatment for cancer than other traditional treatments that can be much harder on the body.
Understanding the Immune System
Different immunotherapy treatments target different components of the immune system. So having a basic understanding of the immune system will help you as you explore immunotherapy for mesothelioma treatment options.
Common terms you should know are:
- Antigens: These are the markings of a foreign invader (such as cancer cells) that trigger a response from your immune system.
- Antibodies: Also known as immunoglobulin, these proteins bind to the invading antigen and either tag it for the immune system to attack or directly neutralize it. Antibodies are produced by B cells.
- Lymphocytes: These white blood cells come in the form of:
- B cells, which produce antibodies.
- T cells, which help the body distinguish between its own cells and foreign cells.
- Killer (Cytotoxic) T cells, which kill cancer cells.
- Dendritic cells: These types of cells help T cells identify foreign antigens.
- Cytokines: These proteins act as messengers to help regulate the immune system’s response to foreign invaders.
- Macrophage cells: These large cells ingest foreign cells.
In addition to understanding these common terms, the Centers for Disease Control and Prevention explains that there are two types of immunity:
- Active immunity, which occurs when the immune system is triggered to act based on exposure to a disease organism (such as mesothelioma cancer cells). Exposure could occur naturally or through vaccination of a weak version of the disease. With active immunity, the immune system remembers the foreign invader and produces antibodies to fight it.
- Passive immunity, which is when a person is given antibodies to fight a disease rather than producing them naturally through the immune system. It is important to note that passive immunity is not long-lasting. It may only last for weeks or months.
What Are the Types of Immunotherapy Drugs Used for Mesothelioma?
The American Cancer Society and the National Cancer Institute outline several types of immunotherapy treatments that could possibly be used to treat mesothelioma:
- Monoclonal antibodies: These immunotherapy drugs are designed to act like immune system proteins. They “mark” mesothelioma cancer cells so the body’s immune system can recognize and attack them.
- Immune checkpoint inhibitors: Normally, molecules on certain immune system cells act as “checkpoints” to tell the body whether a cell is foreign and needs to be attacked, but mesothelioma cancer cells are often able to avoid these checkpoints and grow undetected. Immune checkpoint inhibitors unleash the immune system at these checkpoints so it can identify and attack cancer cells.
- Cancer vaccines: Cancer vaccines aim to boost the immune system’s response to mesothelioma cells. They do this by either directing the white blood cells that fight disease, known as cytotoxic T cells, to recognize and take action against the cancer cells, or by causing the immune system to create more antibodies, which identify and neutralize cancer cells.
- Adoptive cell transfer: This type of treatment involves taking T cells from the tumor to determine which cells are most active in attacking the cancer. These T cells are then modified to make them better at fighting the cancer. Researchers grow batches of these modified T cells in the lab and then inject them back into the patient’s body to boost the immune system’s ability to fight mesothelioma.
- Cytokine Injections: These proteins are made by your body’s white blood cells, and the two main types used to treat cancer are called interferons (INFs) and interleukins (ILs). Man-made versions of these proteins can be injected into patients to help immune system cells grow and divide and increase their ability to fight the cancer cells.
In addition to these emerging immunotherapy drugs, researchers are also exploring other non-specific immunotherapy treatments that could strengthen the immune system in a general way.
Immunotherapy Side Effects
Although the side effects of immunotherapy are usually not as severe as those you may experience from traditional chemotherapy, the National Cancer Institute reports that patients may experience:
- Skin reactions at the site of injection, such as pain, swelling, soreness, redness, itchiness or rash
- Flu-like symptoms such as fever, chills, weakness, dizziness, nausea or vomiting, muscle or joint aches, fatigue, headache, trouble breathing, changes in blood pressure
- Weight gain from retaining fluid
- Heart palpitations
- Sinus congestion
- Diarrhea
- Risk of infection
The side effects a patient experiences will depend both on the person and on the type of treatment received.
How Is This Treatment Given?
- Where you may go for treatment: Depending on the immunotherapy for mesothelioma treatment you are receiving, your clinical trial may require you to go to a doctor’s office, a medical clinic, or a hospital for outpatient treatment.
- What form the treatment may come in: In general, immunotherapy can be given through an injection, intravenously (IV), or in pill form.
- How often you may receive treatment: This will depend on your clinical trial and the type of immunotherapy for mesothelioma treatment you are receiving. You may need treatment daily, weekly, monthly, or in cycles.
Finding an Immunotherapy for Mesothelioma Clinical Trial
Immunotherapy has given many patients hope for another treatment option that may one day help them extend their lives. For now, participating in an immunotherapy for mesothelioma clinical trial is a way for patients to get access to these treatments while being a part of shaping the future of treatment for this devastating type of cancer.
To search for a clinical trial, visit our Mesothelioma Research and Clinical Trials page. You can also contact doctors like Daniel Sterman at NYU.
If you would like to chat with other patients, caregivers or medical professionals about the possibility of an immunotherapy for mesothelioma treatment, please explore our mesothelioma community resources. After all, you are not alone on this journey, and we are here to help.
Sources & Author:
- American Cancer Society: Immune checkpoint inhibitors to treat cancer
http://www.cancer.org/treatment/treatmentsandsideeffects/treatmenttypes/immunotherapy/cancer-immunotherapy-immune-checkpoint-inhibitors - American Cancer Society: What is cancer immunotherapy?
http://www.cancer.org/treatment/treatmentsandsideeffects/treatmenttypes/immunotherapy/immunotherapy-what-is-immunotherapy - Cancer Research UK: Mesothelioma Research
- Cell Adhesion & Migration: What’s the place of immunotherapy in malignant mesothelioma treatments?
- Centers for Disease Control and Prevention:Immunity Types
http://www.cdc.gov/vaccines/vac-gen/immunity-types.htm - Cleveland Clinic: How your own immune system can be used to fight cancer
https://health.clevelandclinic.org/2015/01/how-your-own-immune-system-can-be-used-to-fight-cancer/ - Merck Manual Consumer Version: Overview of the immune system
https://www.merckmanuals.com/home/immune-disorders/biology-of-the-immune-system/overview-of-the-immune-system - Mesothelioma Applied Research Foundation: Mesothelin: A new target for immunotherapy
http://www.curemeso.org/site/c.duIWJfNQKiL8G/b.9147927/k.64C/Mesothelin_A_New_Target_for_Immunotherapy.htm - MesotheliomaHelp.org: Fighting Mesothelioma with Immunotherapy
- National Cancer Institute: How are cancer treatment vaccines designed to work?
https://www.cancer.gov/about-cancer/causes-prevention/vaccines-fact-sheet#q7 - National Cancer Institute: Immunotherapy
- OncoImmunology: Harnessing the antitumor potential of macrophages for cancer immunotherapy
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3902119/ - Penn Medicine: Immunotherapy Drug Pembrolizumab Shows Early Promise for Mesothelioma Patients, Penn Medicine Researchers Find
http://www.uphs.upenn.edu/news/News_Releases/2015/04/alley/ - National Cancer Institute
http://www.cancer.org/cancer/news/features/when-a-friend-has-cancer - Mesothelioma Research
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