Mesothelioma is a rare and aggressive cancer that affects the lining of the lungs, chest wall, abdomen, or heart. It is primarily caused by exposure to asbestos fibers, and the disease has a very poor prognosis, with a median survival time of 12-21 months. Treatment options for mesothelioma include surgery, chemotherapy, radiation therapy, and immunotherapy. Immunotherapy is a relatively new treatment option that has shown promise in treating mesothelioma patients, particularly those who have not responded well to other treatments. In this article, we will discuss the criteria for determining if immunotherapy is appropriate for a mesothelioma patient.
What is Immunotherapy?
Immunotherapy is a type of cancer treatment that works by boosting the body’s immune system to fight cancer cells. The immune system is responsible for identifying and destroying abnormal cells, including cancer cells. However, cancer cells have the ability to evade the immune system, making it difficult for the body to fight off the disease. Immunotherapy helps to “unmask” cancer cells, making them more visible to the immune system, and boosting the body’s natural defenses against cancer.
Types of Immunotherapy for Mesothelioma
There are several types of immunotherapy that have been used to treat mesothelioma patients, including:
Checkpoint inhibitors – These are drugs that block the signals that cancer cells use to evade the immune system. By blocking these signals, checkpoint inhibitors help the immune system to recognize and attack cancer cells.
CAR-T cell therapy – This is a type of immunotherapy that involves engineering a patient’s T cells (a type of white blood cell) to recognize and attack cancer cells.
Immune checkpoint inhibitors – These drugs block the signals that cancer cells use to evade the immune system. By blocking these signals, immune checkpoint inhibitors help the immune system to recognize and attack cancer cells.
Tumor-infiltrating lymphocyte (TIL) therapy – This is a type of immunotherapy that involves removing T cells from a patient’s tumor, growing them in a lab, and then re-infusing them back into the patient’s body to attack the cancer.
Criteria for Determining if Immunotherapy is Appropriate for Mesothelioma Patients
Not all mesothelioma patients are candidates for immunotherapy. Several factors need to be considered before determining if immunotherapy is appropriate for a particular patient. These factors include:
Stage of Mesothelioma – The stage of mesothelioma is one of the most critical factors in determining if immunotherapy is appropriate. Immunotherapy is most effective in patients with early-stage mesothelioma, where the cancer is localized and has not spread to other parts of the body. In later stages of the disease, when the cancer has spread to other parts of the body, immunotherapy is less likely to be effective.
Tumor Biomarkers – Tumor biomarkers are proteins or other substances that are produced by cancer cells. Some biomarkers are associated with a better response to immunotherapy, while others are associated with a poorer response. For example, patients with mesothelioma who have high levels of PD-L1 (a protein found on some cancer cells) are more likely to respond to immunotherapy with checkpoint inhibitors.
Overall Health of the Patient – Immunotherapy can be a demanding treatment, and patients need to be in good overall health to tolerate it. Patients with other medical conditions, such as heart disease or diabetes, may not be good candidates for immunotherapy.
Previous Treatments – Patients who have not responded well to other treatments, such as chemotherapy or radiation therapy, may be good candidates for immunotherapy. Immunotherapy works by boosting the body’s immune system, so patients who have a weakened immune system due to previous treatments may not respond as well to immunotherapy.
Patient Preferences – Finally, patient preferences must be taken into account when considering immunotherapy. Immunotherapy can be a demanding treatment that requires frequent hospital visits and may have side effects. Patients must be willing to undergo the treatment and understand the potential benefits and risks.
Conclusion
Immunotherapy is a promising treatment option for mesothelioma patients, particularly those who have not responded well to other treatments. However, not all patients are candidates for immunotherapy, and several factors need to be considered before determining if it is appropriate. The stage of mesothelioma, tumor biomarkers, overall health of the patient, previous treatments, and patient preferences are all critical factors that must be taken into account when considering immunotherapy. Patients should discuss their treatment options with their healthcare provider to determine if immunotherapy is appropriate for their particular case.
