The Five Pillars of Mesothelioma Treatment

For decades, the cancer community has acknowledged surgery, chemotherapy, and radiation therapy as the pillars of cancer treatment. Two decades ago, targeted therapies emerged as the fourth option, and immunotherapy was named the fifth pillar. Vaccines, CAR T-cell therapy, monoclonal antibodies, and cytokines are all examples of immunotherapies.

What Is Immunotherapy?

Immunotherapy is a form of cancer treatment that strengthens the immune system, enabling it to fight off disease more efficiently. Some forms of this treatment have successfully reduced the size of cancerous tumors in patients.

A type of immunotherapy that’s quickly gaining recognition is called chimeric antigen receptor T-cell therapy, or CAR T-cell therapy.

CAR T-cell Therapy

This treatment option is FDA-approved to treat specific cancers and focuses on boosting the body’s T-cells (cells designed to find and attack abnormal cells, including cancer). The process begins with a doctor extracting T-cells from the patient’s blood, and then adding artificial receptors to them (the “chimeric antigen receptor” or CAR). These receptors work as “heat-seeking missiles,” helping the cells produce chemicals that fight cancer. Sometimes these cells evade the immune system, and CAR T-cell therapy gets the system back on track, helping it to better target and fight off disease.

How Likely Is CAR T-cell Therapy to Work?

Every patient and cancer diagnosis is unique, and the results will vary. Your oncologist will provide you with a treatment plan, and prognosis after a mesothelioma diagnosis. Patients who want to explore other options should consider seeking a second opinion from a specialist.

Many variables determine how well the treatment works, including:

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Clinical Trials for CAR T-cell Therapy

Doctors and researchers developed and tested CAR T-cell therapy through different clinical trials. These studies help determine the safety and effectiveness of emerging treatments before they are made available to the public. Clinical trials are conducted in hospitals, medical offices, community clinics, and universities. Typically, there is a principal investigator, often a doctor, and a team of additional doctors, nurses, and other medical professionals.

One particular clinical trial for CAR T-cell therapy began in 2015 and involved 21 people — 19 with pleural mesothelioma, one with breast cancer, and one with metastatic lung cancer. Doctors and researchers observed patients and took body scans to measure tumor size after treatment. In 13 of the patients, tumors shrunk significantly. Two patients even exhibited a complete metabolic response, which means “no evidence of disease.” Based on further findings from this study, the longer CAR T-cells remained in the blood, the more effective the therapy was.

Risks and Side-Effects of CAR T-cell Therapy

As with most cancer treatments, there is always a possibility for negative side-effects. With CAR T-cell therapy, the most frequent side-effect is cytokine release syndrome, (CRS). When a patient develops CRS, their body reacts by rapidly and massively releasing cytokines into the bloodstream, which can cause dangerously high fevers and severe drops in blood pressure.

Ironically, the development of CRS in a patient is synonymous with how well the treatment is working in the first place. So if the modified T-cells are actively at work fighting tumors in the body, a patient with an extensive form of disease before treatment could be more likely to develop severe CRS. Consult with an oncologist to determine your personal risk factors.

Other side effects for CAR T-cell therapy includes a mass “die-off” of B-cells, otherwise known as B-cell aplasia. B-cells are produced in the bone marrow of each patient. They fight bacteria and viruses by producing proteins called antibodies. B-cells utilize antibodies (specific to each pathogen) by attaching onto the surface of an invading cell and marking it, causing other immune cells to attack. Patients who develop B-cell aplasia are at a much higher risk of incurring infections.

Explore Your Treatment Options

Overall, CAR T-cell therapy has shown significant promise in treating mesothelioma and other cancers. If an oncologist has diagnosed you or a loved one with mesothelioma, ask about treatment options like CAR T-cell therapy. If you were unknowingly exposed to asbestos on the job, you may be eligible for compensation to cover your medical bills. Complete a free case evaluation to learn more.

Mesothelioma Support Team

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