Historically, mesothelioma has been difficult to treat. Although treatment options exist, the cancer tends to respond poorly which results in a higher mortality rate. Improving patient care and outcomes (such as longer lifespan) is crucial, so more recent research has centered around improving survivability. An article from Baylor College of Medicine discussed one of these research studies regarding the use of preoperative immunotherapy treatment for people living with resectable (able to be removed surgically) malignant pleural mesothelioma (MPM).

In their work, published in Clinical Cancer Research, the scientists shared their hypothesize: that surgery, in conjunction with another therapy, would be beneficial for people with MPM. More specifically, prior research which highlighted the efficacy of immunotherapy for people with unresectable mesothelioma prompted the researchers to consider immunotherapy as a neoadjuvant (delivered before treatment) therapy. The research team wanted to determine whether neoadjuvant immunotherapy could increase the immune response to tumor cells that will last even after the tumor has been removed.

To begin their study, the research team first split participants in two separate cohorts. One received durvalumab only, while the other received durvalumab and tremelimumab. Next, the researchers evaluated how the participants’ tumors responded to treatment post-surgery. They found that combining the two immunotherapies (durvalumab and tremelimumab) improved overall survival rates, made the tumor microenvironment less favorable for tumor survival, and heightened the number of immune cells that play a role in attacking the tumor.

While these results do show promise, more research is needed. In the future, the research team hopes to launch a more comparative study to deeper understand how neoadjuvant immunotherapy helps patients as opposed to other forms of treatment.

About Malignant Pleural Mesothelioma (MPM)

Considered to be the most common mesothelioma subtype, malignant pleural mesothelioma (MPM) is a rare cancer that forms in the pleura, or the lining of the lungs. Asbestos exposure causes MPM. After inhaling asbestos fibers, they become trapped or embedded in the pleura, causing damage, scarring, inflammation, and even tumor formation. Because mesothelioma takes years to develop, many people are not diagnosed until they’re in their 60s or later. Symptoms, once present, may include:

• Chest pain
• Shortness of breath and/or difficulty breathing
• Dysphagia (difficulty swallowing)
• Painful breathing
• Fatigue
• Pleural effusion (fluid in the lungs)
• Fever and night sweats
• Unintended weight loss
• A dry cough or, alternately, a cough that produces blood
• Lower back and/or rib pain
• Swelling of the face and/or arms

Chemotherapy and surgical resection are the two most common treatment options. However, researchers are evaluating a wealth of other therapies for people with MPM to help them live longer.