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Targeted Therapies and Mesothelioma

For most patients, doctors use targeted therapies to treat mesothelioma and other cancers. In general, targeted treatments use medications that detect abnormal changes in cancer cells — changes that don’t exist in healthy cells. Since this treatment can distinguish between diseased and healthy cells, patients who receive this type of treatment will experience significantly fewer side-effects compared to traditional options like chemotherapy or radiation.

Today, targeted therapies are still relatively new. Currently, researchers are developing, modifying, and testing them in clinical trials. One type of targeted therapy being tested on mesothelioma and other cancers is called photodynamic treatment (PDT), which uses a laser to activate cancer-killing drugs in the patient.

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What is Photodynamic Treatment?

For patients in cancer treatment, photodynamic treatment is a therapy designed to kill cancer cells without sacrificing the surrounding tissues. Developed in the 1970s by Thomas Dougherty, Ph.D., the treatment involves administering a nontoxic drug directly onto the tumor cells. This drug makes these cells ultrasensitive to light, but otherwise, it doesn’t affect the body. Then, a laser is applied to the tumor in order to activate the medication and kill the marked cells.

Porfimer sodium, also known as Photofrin, is the PDT photosensitizer most commonly used for this treatment. The substance is inserted into cells and activated by a red light from a laser. It’s approved by the FDA and can help patients with the following cancers:

  • Esophagus cancer
  • Non-small cell lung cancer

Also, PDT can be used in combination with other primary mesothelioma treatments, like surgery. The combination of these two therapies has been known to improve survival rates and quality of life for patients in earlier stages of the disease.

Who’s Eligible?

Your mesothelioma specialist or oncologist will be able to determine the best treatment options for you. Each patient’s case is different, meaning that different treatment-plans will be assigned to each person. Variables that may impact your eligibility include your general health, mesothelioma stage, and other factors determined by your cancer care team. Generally, patients in the earlier stages of cancer have the highest chance of benefitting from targeted therapies, but your doctor will be able to make the final determination.

Patients with the following health issues may not be eligible for PDT:

  • Fistula (irregular opening) between the esophagus and windpipe or one of the lower breathing tubes
  • Any tumor that’s near or spreading to a major blood vessel
  • An allergy to porphyrins, or porphyria

Side-Effects of PDT

While the side-effects and symptoms of photodynamic treatments are less severe than chemotherapy or radiation, they still exist. If you or a loved one start to notice any side-effects, contact a doctor immediately.

Side-effects of photodynamic treatment can include photosensitivity reactions (activated by light) to porfimer sodium. Swelling may also occur in the treated area, which may cause issues with pain, breathing, or swallowing. Other possible side-effects can include:

  • Dehydration
  • Fever
  • Fluid in the lungs
  • Headache
  • Nausea
  • Problems Swallowing
  • Scarring and narrowing of the esophagus
  • Vomiting

Why Photodynamic Therapy?

Photodynamic treatment is a less invasive method of treatment for mesothelioma patients. Some other advantages of PDT include:

  • Allowing the doctor to target cancer cells more precisely
  • The ability to apply treatment multiple times as needed
  • A more cost-effective form of therapy
  • Not as invasive than other methods
  • No long-term side effects
  • Shorter treatment and recovery time

PDT does have restrictions, some include:

  1. It can’t be used to treat cancers that have already metastasized (spread) to multiple places in the body
  2. PDT is only effective in areas just under the skin or in the lining of the organs, where light can penetrate
  3. Medications utilized in treatment can cause some patients to develop light-sensitivity
  4. Patients with specific reactions or blood illnesses cannot undergo this treatment

Photodynamic Treatment Centers

Only certain hospitals and cancer centers offer photodynamic therapy to patients, and many are through clinical trials. These trials are research studies that involve researchers and patients. Several clinical trials for mesothelioma can be located through the National Cancer Institute. The Roswell Park Comprehensive Cancer Center also hosts PDT clinical trials for patients.

Talk With Your Doctor About Treatment Options

Your doctor will be able to provide you with additional information on photodynamic treatment. Let them know this is a treatment option you want to pursue, and they’ll evaluate your case and let you know if PDT is the right choice for you.

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