Malignant pleural mesothelioma (MPM) is a rare and aggressive cancer that affects the lining of the lungs, chest wall, and pleura. This cancer is caused by exposure to asbestos, and it has a poor prognosis. Biphasic MPM is a subtype of this cancer that has both epithelioid and sarcomatoid components. Targeted therapies are a type of cancer treatment that focuses on specific molecular targets in cancer cells. There are several targeted therapies available for the treatment of biphasic MPM, but like all cancer treatments, they can have potential side effects.
The most common targeted therapy used for biphasic MPM is bevacizumab. Bevacizumab is a monoclonal antibody that targets vascular endothelial growth factor (VEGF), a protein that promotes the growth of blood vessels in tumors. By blocking VEGF, bevacizumab can starve tumors of blood supply and slow down their growth. However, bevacizumab can have several side effects, including:
Hypertension: Bevacizumab can cause an increase in blood pressure, which can lead to headaches, dizziness, and vision changes. Patients receiving bevacizumab may need to monitor their blood pressure regularly and take medications to control it.
Bleeding: Bevacizumab can increase the risk of bleeding, especially in the digestive tract or lungs. Patients may experience coughing up blood, black or tarry stools, or abdominal pain. They should report any signs of bleeding to their healthcare provider immediately.
Blood clots: Bevacizumab can increase the risk of blood clots, which can lead to stroke, heart attack, or pulmonary embolism. Patients may need to take blood-thinning medications to prevent blood clots.
Impaired wound healing: Bevacizumab can impair wound healing, which can be a concern for patients who need surgery or have wounds that need to heal. Patients should inform their healthcare provider if they are scheduled for surgery or have any wounds that need to heal.
Another targeted therapy used for biphasic MPM is pembrolizumab. Pembrolizumab is a monoclonal antibody that targets programmed cell death protein 1 (PD-1), a protein that inhibits the immune system’s ability to recognize and attack cancer cells. By blocking PD-1, pembrolizumab can help the immune system recognize and attack cancer cells. However, pembrolizumab can have several side effects, including:
Fatigue: Pembrolizumab can cause fatigue, which can be severe in some patients. Patients may need to rest more and reduce their physical activity.
Skin rash: Pembrolizumab can cause a skin rash, which can be itchy and uncomfortable. Patients may need to use topical creams or take oral medications to relieve the rash.
Diarrhea: Pembrolizumab can cause diarrhea, which can be watery and frequent. Patients may need to drink more fluids and take medications to control the diarrhea.
Immune-related side effects: Pembrolizumab can cause immune-related side effects, such as pneumonitis (inflammation of the lungs), colitis (inflammation of the colon), or hepatitis (inflammation of the liver). These side effects can be severe and require immediate medical attention.
A third targeted therapy used for biphasic MPM is nivolumab. Nivolumab is also a monoclonal antibody that targets PD-1. Like pembrolizumab, nivolumab can have several side effects, including:
Fatigue: Nivolumab can cause fatigue, which can be severe in some patients. Patients may need to rest more and reduce their physical activity.
Skin rash: Nivolumab can cause a skin rash, which can be itchy and uncomfortable. Patients may need to use topical creams or take oral medications to relieve the rash.
Diarrhea: Nivolumab can cause diarrhea, which can be watery and frequent. Patients may need to drink more fluids and take medications to control the diarrhea.
Immune-related side effects: Nivolumab can cause immune-related side effects, such as pneumonitis (inflammation of the lungs), colitis (inflammation of the colon), or hepatitis (inflammation of the liver). These side effects can be severe and require immediate medical attention.
In conclusion, targeted therapies for biphasic MPM can have potential side effects, including hypertension, bleeding, blood clots, impaired wound healing, fatigue, skin rash, diarrhea, and immune-related side effects. Patients receiving targeted therapies should be closely monitored for these side effects and receive prompt medical attention if they occur. It is essential to weigh the potential benefits and risks of targeted therapies with the patient’s healthcare provider to determine the best treatment plan for each patient.
