Scientists Use Body’s Own Anti-Cancer Tools Against Mesothelioma, While Study Shows Women More Likely To Survive The Cancer
Italian researchers have found that an anti-cancer protein naturally produced by the body can be enhanced in the laboratory and used to fight mesothelioma, while a new study across more than 14,000 US mesothelioma patients has found that women are much more likely to survive the cancer. Taken together, these results provide new windows onto understanding why some people (such as Paul Kraus, survivor of mesothelioma for more than 17 years) might do so much better against the disease than others.
Italian Researchers Use Body’s Own Anti-Cancer Tools To Fight Mesothelioma
Looking at a protein known as TNF-Related Apoptosis-Inducing Ligand, or TRAIL, Italian researchers have found what may be a promising new mesothelioma therapy. The TRAIL protein is a cytokine which most normal tissue cells produce, and which results in programmed cell death (or apoptosis) in tumor cells. TRAIL is therefore one of the body’s natural defenses against cancers such as mesothelioma.
The researchers, working out of the University of Padua, attempted to see whether laboratory-produced TRAIL protein (which had been derived from human cells) could be combined with standard chemotherapy to produce a better outcome against the otherwise difficult-to-treat pleural form of mesothelioma. To test this, they administered the laboratory-produced TRAIL (which is known as dulanermin) in combination with pemetrexed and carboplatin to mesothelioma cancer cells “in the petri dish” as well as to lab mice which had human mesothelioma.
The results were very promising. Mesothelioma cells which were treated with the chemotherapy and dulanermin mix died off at a significantly faster rate. Even better, in both the mice and in the lab cells, the combination of dulanermin and chemotherapy produced a better result than either chemotherapy or dulanermin on their own.
According to the doctors, dulanermin appears to block mesothelioma growth through activating certain anti-cancer genes. For example, other studies have shown that cancer proliferates when the cells’ p53 tumor-suppressor gene is inactive or mutated. By combining dulanermin with chemotherapy, dulanermin appears to enhance the sensitivity of cancer cells to the apoptosis-inducing effects of chemotherapy.
Further examination showed that chemotherapy actually increased the activation of the p53 tumor-suppressor gene and increased the number of TRAIL receptors, indicating that chemotherapy also increased the sensitivity of cancer cells to TRAIL/dulanermin also.
If other researchers are able to replicate these results, human trials of dulanermin combination treatment would be next.
Women Have Triple The Mesothelioma Survival Rate As Men
Analyzing 14,228 cases of pleural mesothelioma (22% of which were women), a group of cancer researchers from New York found that despite the lower incidence of cancer in women, women who develop mesothelioma are three times as likely to survive as men. Five years after diagnosis, just over 13% of women diagnosed with cancer were still alive — whereas the same was true for just 4.5% of men diagnosed with mesothelioma.
Unfortunately, the study was not able to determine the cause of this significant survival gap, nor to answer why some of the longest-living mesothelioma patients (such as Paul Kraus, survivor and author) are male. The researchers suggest that different levels of asbestos exposure, differences in hormones for male or female patients, or tumor biology might be the cause.Read More
Standard Mesothelioma Therapies Still Best — But For Peritoneal Mesothelioma Patients, A Second Round Helps
Underscoring the comparative effectiveness of standard mesothelioma therapies, researchers in Japan and the US have examined standard treatments for pleural and peritoneal mesothelioma and found them to be effective. However, for peritoneal mesothelioma patients, a second round of the standard treatment for that disease can improve matters even more.
Standard Pleural Mesothelioma Chemotherapy Still Best
Comparing the popular and well-understood combination of Alimta (pemetrexed) and cisplatin chemotherapy with Gemzar (gemcitabine) chemotherapy for treating malignant pleural mesothelioma, researchers from Juntendo University and Shizuoka Cancer Center say the Alimta-based treatment should remain standard.
The new drug, Gemzar (gemcitabine), is a type of nucleoside analog which has produced promising results in some studies compared with the conventional Alimta treatment. Both drugs are combined with cisplatin in clinical practice.
Examining 30 consecutive cases of patients suffering from malignant pleural mesothelioma from July 2002 until December 2011, the researchers found 17 were treated with the Alimta-cisplatin combination and 13 with the Gemzar-cisplatin mix.
Overall, 35% of Alimta patients responded to the treatment, while just 15% of those treated with Gemzar did. Also, patients who were treated with Alimta had much longer until their tumors started growing again than the Gemzar patients — a median time of 215 days versus 142 days. Alimta-treated patients also survived longer, a median 1 year 7 months, than did the Gemzar-treated patients (median 10 months)
Comparing side effects, the Japanese researchers noted both treatments came with significant downsides, but Alimta still came out ahead here also. According to their paper, both Alimta-cisplatin and Gemzar-cisplatin treatments produced abnormally low platelet counts and drops in neutrophil white blood cell counts, but Gemzar-treated patients experienced more severe and more frequent versions than did the Alimta-treated ones.
For Peritoneal Mesothelioma Patients, A Second Round Helps
Patients with peritoneal mesothelioma patients have an option which is not available to pleural mesothelioma patients: known as heated intraperitoneal chemotherapy or HIPEC, the technique involves washing a heated solution of chemotherapy drugs through the abdominal cavity after surgeons remove as much tumor mass as possible.
According to new research from the US Moffitt Cancer Center, this treatment can be performed multiple times for even greater effect, which may be a promising option for patients who qualify for it.
Focusing on 29 different patients who underwent a surgical procedure to treat peritoneal mesothelioma at the Moffitt hospital between the periods of June 2004 and March 2012, they found all but three were treated with HIPEC immediately following the surgery. Of the patients who had HIPEC, another 8 came back later for a second HIPEC round in order to slow down or halt their mesothelioma’s regrowth.
Overall, for these 8 patients, the first and second surgeries showed no major differences. The patients had similar lengths of time in the operating room, similar levels of blood loss, and their hospital stays were about as long. Doctors used cisplatin as the chemotherapy drug in both cases. The primary difference was that the second round produced a lower rate of complications than the first — 50% vs 65%.
Comparing the patients who’d only had a single surgery and HIPEC treatment with the ones who’d had a second HIPEC round, the researchers found that the second round had a significant benefit. While the first group, who only underwent HIPEC once, survived a median 27.2 months, patients who underwent a second round of HIPEC had a median survival time of 80 months. This suggests that, for patients who are candidates for repeat HIPEC, the procedure produces a major survival advantage.
Disclaimer: The information in this article is for educational and informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this article. This article was written by a third party and its content reflects the views of the third party and does not necessarily reflect the views or opinions or of Surviving Mesothelioma or Cancer Monthly.Read More