Using Immunotherapy to Treat Mesothelioma

Summary

When used with other primary therapies, immunotherapy can shrink or prevent tumors from coming back because the body’s immune system can recognize the cancer cells as dangerous and fight them off.

Immunotherapy Explained

Immunotherapy uses the body’s own immune system to fight mesothelioma by teaching the body to recognize cancer cells as harmful or by helping the body’s immune system kill the cancer cells.

Unlike other forms of mesothelioma treatment such as chemotherapy or radiation therapy, immunotherapy only goes after mesothelioma cells, leaving the healthy tissue surrounding the tumor alone. Because healthy tissue is unaffected, patients recover easier from procedures because their bodies don’t have the added step of needing to heal the healthy tissue.

How Immunotherapy Works

Whenever someone gets sick, their body’s immune system kicks into action to fight off the viruses or other forms of infection, allowing the individual to get better. However, because mesothelioma cells are normal lung cells that have mutated, it’s harder for the immune system to notice something is wrong.

Sometimes the body is able to recognize there is a problem, but the immune system is unable to keep up and fight off the tumor because the cancer cells grow and multiply so quickly.

This is where immunotherapy comes in. When a patient receives immunotherapy, they are given specific types of drugs that help the body fight off the tumor in a couple of different ways. Immunotherapy can be either active or passive.

Active Immunotherapy

Active immunotherapy works like a vaccine and teaches the patient’s immune system to recognize cancer cells and realize that they are harmful to the body.

The drugs used in active immunotherapy do this by triggering checkpoint inhibitors, or molecules, on the cancer cells that will start an immune response when they are activated. However, before they are activated, they protect the cells they are attached to by convincing the body’s immune system that they are not harmful.

Cancer cells tend to have many of these molecules. Active immunotherapy strives to activate the particles so that the body tries to fight off the cancer cells instead of merely letting the tumor grow.

Some of the immunotherapy drugs that can be used to activate the checkpoint inhibitors are:

  • Keytruda
  • Opdivo
  • Yervoy

Passive Immunotherapy

Once the body can recognize that cancer cells are harmful, then passive immunotherapy can help the immune system kill the cancer cells and stop the tumor from spreading.

Passive immunotherapy works by using lab-created antibodies, which are also known as monoclonal antibodies, to target antigens, or specific proteins, that are found on cancer cells.

These monoclonal antibodies work in several different ways. One way the antibodies work is by attaching to the antigens on the cancer cells and preventing them from growing and spreading.

Benefits of Immunotherapy for Mesothelioma Treatment

There are many benefits of using immunotherapy in conjunction with other treatment programs such as chemotherapy. One benefit is that it improves patient survival rates.

MJN Brief

According to a 2017 study by Dr. Gerard Zalcman, the one-year survival rates for mesothelioma patients was 51% when they were taking nivolumab or Opdivo, and 58% if they combined that drug with ipilimumab.

Another benefit of using immunotherapy is that it uses the patient’s own natural defense system to attack the cancer cells—meaning fewer side effects and less damage to healthy tissue surrounding tumors.Patient recovery times are faster and more comfortable than with other treatment programs.

Immunotherapy Combination Treatments

Doctors often use immunotherapy in combination with other treatment plans like chemotherapy, virotherapy and surgery.

Chemotherapy and Immunotherapy:

Researchers are aware that it’s vital for the body’s immune system to recognize cancer cells as harmful so that it can control, prevent and shape the tumors growing in the patient’s body. However, some chemotherapies are ineffective when it comes to teaching the body’s immune system to recognize and attack cancer cells.

While the chemotherapy fights off cancer, active immunotherapy can fill in the gap, teaching the immune system to recognize cancer cells as harmful.

Virotherapy and Immunotherapy:

In virotherapy, viruses are altered so that they duplicate themselves better inside tumor cells than in healthy cells. Then immunotherapy can be used to help the body better fight off the virus in the tumor, causing the immune system to attack the cancer cells at the same time.

Surgery and Immunotherapy:

Immunotherapy can be used as an adjuvant or additional therapy after a patient has had surgery. Immunotherapy after surgery reduces the risk of recurrence by enabling the body to recognize and fight off cancer cells that are trying to spread and grow.

Immunotherapy Research and Advancements

In addition to the study by Dr.Gerard Zalcman, there was a clinical trial from France called MAPS2. Unfortunately, all patients who are diagnosed with mesothelioma relapse once they stop receiving treatment.

MJN Brief

For 50% of mesothelioma patients, recurrence will happen within 6 months after stopping treatment. Research such as the MAPS2 trial—which looks into new treatment methods or ways to make current treatments more useful—is critical for preventing mesothelioma recurrence.

The MAPS2 clinical trial showed that immunotherapy slowed down the growth of pleural mesothelioma after a relapse. The study had 125 patients. After 12 weeks of treatment using Opdivo, the mesothelioma did not grow larger or spread further in 44% of the patients.This percentage increased to 50% when the patients received both Opdivo and Yervoy. In fact, in 17% of the patients who received just the Opdivo and 26% of the patients who received the combination, the tumor actually shrank.

Immunotherapy Side Effects

While immunotherapy has fewer side effects than other cancer treatments, it still has some. These side effects may be different for each person, and they will depend on the specific drugs and types of immunotherapy being done.

Some of the possible immunotherapy side effects include:

  • Weight gain due to the patient’s body holding in more fluids
  • Infection near the injection site, which appears as pain or itching and burning sensation near the site
  • Flu-like symptoms such as fever, chills, nausea and congestion
  • Changes to the  patient’s blood pressure or heart palpitations
  • Trouble breathing, tiredness, dizziness or muscle pains

Seeking Immunotherapy Treatment for Mesothelioma

Mesothelioma therapies continue to evolve as researchers look for novel ways to boost immune system function in the fight against mesothelioma. Immunotherapy is a promising treatment that can enhance and improve standard mesothelioma treatments and treatment combinations.

Patients who are looking to use immunotherapy to help treat their mesothelioma should speak with their oncology team. Or contact The Mesothelioma Justice Network to help you find the appropriate care practitioner.

View Author and Sources
Sources
  1. American Cancer Society. “Immune checkpoint inhibitors to treat cancer.” Retrieved from: https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/immunotherapy/immune-checkpoint-inhibitors.html. Accessed May 8, 2018.
  2. American Cancer Society. “Monoclonal antibodies to treat cancer.” Retrieved from: https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/immunotherapy/monoclonal-antibodies.html. Accessed May 8, 2018.
  3. Fisher, Alise. “Early Research Suggests First Immunotherapy for Mesothelioma on the Horizon.” Retrieved from: https://www.asco.org/about-asco/press-center/news-releases/early-research-suggests-first-immunotherapy-mesothelioma. Accessed May 3, 2018.
  4. Grégoire, Marc. “What’s the place of immunotherapy in malignant mesothelioma treatments?” Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2852572/. Accessed May 3, 2018.
  5. National Cancer Institute. “Immunotherapy to Treat Cancer.” Retrieved from: https://www.cancer.gov/about-cancer/treatment/types/immunotherapy. Accessed May 3, 2018.
  6. Welch, Angelica. “Immunotherapy Impact Extends to Mesothelioma.” Retrieved from: https://www.onclive.com/web-exclusives/immunotherapy-impact-extends-to-mesothelioma?p=1. Accessed May 3, 2018.

Last modified: May 30, 2018