Oncology Central

Exploring treatment options for mesothelioma: an interview with Thomas John

Mesothelioma is a cancer that most commonly starts in the pleura, layers of tissue that cover each lung. More rarely it starts in the peritoneum, the layer of tissue in the abdomen that surrounds the digestive system organs. Yet no matter where it presents patients typically receive a poor prognosis of 12-21 months upon diagnosis. In this interview you can discover the current treatment options for mesothelioma, advancements that have been made in immunotherapy for this disease and what is being done to advance patient selection for this treatment modality.

Could you tell us about the current treatment options for mesothelioma?

There are several trials now incorporating anti-angiogenic agents and immunotherapies into the standard treatment paradigms for mesothelioma. However standard therapy is still platinum/pemetrexed with the addition of bevacizumab if available.

Following this, immunotherapy is becoming a more realistic option. There are currently no approved immunotherapies, however some patients have been able to access drugs such as pembrolizumab (Keytruda) through co-payment schemes.

More novel trials are investigating antibody drug conjugates where chemotherapy is bound to a targeting antibody. This way the chemotherapy is only delivered to cancer cells, potentially sparing the side effects which occur from normal cell death.

Could you tell us about some of the anti-angiogenic agents for malignant mesothelioma?

Currently the only available therapy is an antibody to VEGF termed bevacizumab. It was shown to be effective in a large French study although has not changed treatment paradigms in many countries. Many other anti-angiogeneic agents have been trialed including thalidomide, sorafeninb, sunitinib and others (reviewed here Chia et al Targeting the vasculature: antiangiogeneic agents for malignant mesothelioma 2016).

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