Newly approved therapies and encouraging clinical trials give hope to patients and doctors.
Hedy Lee Kindler, a specialist for mesothelioma, is a prime example.
Dr. Kindler is the Director of the Mesothelioma Program at University of Chicago Medicine. She authored a paper in the American Society of Clinical Oncology’s journal. Her words offer a hopeful future on survival and treatment due to recent advancements of the past few years.
“After over a decade of stagnation,” she wrote, “it appears that we have finally turned the corner in our battle against this devastating disease.”
Most notably, Dr. Hedy Kindler questioned whether patients with sarcomatoid mesothelioma are surgical candidates thanks to immunotherapy’s rise. This sentiment hasn’t been expressed often among specialists due to the nature of sarcomatoid cells. They’re tougher to identify and grow quicker, making surgery more challenging.
In 2020, the U.S. Food and Drug Administration (FDA) approved nivolumab (Opdivo) and ipilimumab (Yervoy) for mesothelioma. The median survival shows why:
- 18 months for Opdivo and Yervoy, two immunotherapy drugs
- 14 months for chemotherapy, which was already approved by the FDA
“How should we incorporate immunotherapy-based treatment into multimodality treatment regimens?” she asked in the paper. “Although the goal of surgery for mesothelioma is maximal surgical debulking, a (complete) resection is rarely achieved and systemic therapy is generally required. Will immunotherapy or chemoimmunotherapy prove to be superior in this setting as well?”
The biggest improvement was for sarcomatoid cell types. The survival for this group often doubled compared to chemotherapy.
“Given the durable disease control achieved in some patients with immunotherapy alone, is surgery truly necessary?” she continued. “Conversely, although surgery is not currently recommended for non-epithelioid histology, should we now consider these patients as candidates for subsequent resection, given the remarkable results achievable with immunotherapy?”
Other trials – for durvalumab, bevacizumab and pembrolizumab – may add options. The rise of cell therapies, such as CAR T cells, open up more approaches for personalized, targeted therapy on a patient-by-patient basis.
Whatever the future holds, Dr. Kindler views it as much brighter than the past has been for the mesothelioma community.
Sources & Author
- Systemic Therapy for Mesothelioma: Turning the Corner. American Society of Clinical Oncology. Retrieved from: https://ascopubs.org/doi/10.1200/OP.21.00785?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed. Accessed: 12/27/2021.
Sources & Author