The 5th International Symposium on Lung-Sparing Therapies for Malignant Pleural Mesothelioma was held in Santa Monica, CA on May 2, 2015. The audience included pulmonary physicians, medical oncologists, surgical oncologists, patients and family members. Speakers covered everything from staging mesothelioma to current routes of treating the disease, but the most notable takeaways involved novel treatments, especially immunotherapy.
Acclaimed mesothelioma specialist Dr. Robert Cameron was a featured speaker at the symposium. Considering that he is the developer of the lung-sparing surgery pleurectomy/decortication (P/D) for pleural mesothelioma, it’s not surprising that part of the symposium involves discussions about the pros and cons of surgery for pleural mesothelioma. The extrapleural pneumonectomy (EPP) is the lung-removing surgical contender to the P/D.
Dr. Cameron has always been a proponent of the physician’s mantra “do no harm.” In fact, he is emphatic about this motto when explaining his rationale in treating his patients.
“Taking out a lung does harm and there is absolutely no benefit to the patient,” he says on the Pacific Meso Center website.
This is a contentious point-of-view, as many specialists concede that there is a time and place for both procedures. However, the symposium is about much more than surgical techniques. After all, any treatment that doesn’t involve removing the lung is a lung-sparing treatment.
Successful Immunotherapy on the Horizon
“The most interesting research presented this year involved advances in immunotherapy,” Dr. Cameron in a Pacific Meso Center press release. “While we still don’t understand everything about how the immune system works, it is encouraging that we are making headway.”
Immunotherapy drugs could be the future of mesothelioma treatment. These drugs stimulate the immune system to attack mesothelioma throughout the body. What’s better is that immunotherapy drugs specifically target mesothelioma cells, leaving most healthy cells unharmed.
The destruction of healthy cells is the cause for the side effects of most cancer treatments. Unlike traditional chemotherapy, which doesn’t discriminate between healthy and cancerous cells, immunotherapy is more tolerable for patients.
But the most promising thing about immunotherapy has to do with they way mesothelioma specialists are beginning to look at treatment. Many, including Dr. Cameron, champion a managed approach to the disease. Understanding that it is improbable to eradicate the disease, they hope to keep it under control with immunotherapy. Drugs like the cancer vaccine CRS-207 are already producing results; patients are living longer than ever by managing their illness.
Where the Research Is Now
There were mesothelioma doctors and researchers from various backgrounds present at the symposium. These specialists presented their research and explained future possibilities in mesothelioma treatment. Some of the notable speakers at the symposium included:
- Dr. J. Andrea McCart. As a researcher at Toronto General Research Institute, Dr. McCart has studied oncolytic viruses to treat mesothelioma. She researches the genetic modification of the vaccinia virus (the virus that causes smallpox), so that it infects and destroys mesothelioma cells without harming the patient. This drug, GL-ONC1, is the subject of an ongoing clinical trial.
- Dr. Marc de Perrot. Dr. de Perrot is a thoracic surgeon at the University of Toronto. He has led research on a new multimodal surgical approach to mesothelioma known as SMART (Surgery for Mesothelioma After Radiation Therapy). His research has concluded that applying radiation before surgery is potentially far more effective than radiation after surgery.
- Dr. Raymond Wong. Working as a researcher with PMC, Dr. Wong is intent on studying immunotherapy for mesothelioma. He has studied the effects of cancer vaccines, immune checkpoint inhibitors and how drugs like these may work together.
Annual meetings, such as PMC’s symposium, create opportunities for researchers to share their findings and further the treatment of mesothelioma. This year, the focus on immunotherapy is a result of progress in this area of treatment.
“The improved knowledge that we now have regarding the immune system, compared to 30 years ago, is translating rapidly into real therapies,” Dr. Cameron said.