Treatment of Mesothelioma
Symptoms | Diagnosis | Pathophysiology | Epidemiology | Treatment | Research | Legal Issues | History
Treatment of Mesothelioma using conventional therapies has not proved successful and patients have a median survival time of 6 - 12 months after presentation. The clinical behaviour of the malignancy is affected by several factors including the continuous mesothelial surface of the pleural cavity which favours local metastasis via exfoliated cells, invasion to underlying tissue and other organs within the pleural cavity, and the extremely long latency period between asbestos exposure and development of the disease.
Surgery, either by itself or used in combination with pre- and post-operative adjuvant therapies has proved disappointing with a 5 year survival rate of less than 10%. Although the tumour is highly resistant to radiotherapy and chemotherapy, these regimens are sometimes used to relieve symptoms arising from tumour metastases such as obstruction of a major blood vessel.
Treatment regimens involving immunotherapy have yielded variable results. For example, intrapleural inoculation of Bacillus Calmette-Guérin (BCG) in an attempt to boost the immune response, was found to be of no benefit to the patient. Mesothelioma cells proved susceptible to in vitro lysis by LAK cells following activation by interleukin (IL)-2, but patients undergoing this particular therapy experienced major side effects. Indeed, this trial was suspended in view of the unacceptably high levels of IL-2 toxicity and the severity of side effects such as fever and cachexia. Nonetheless, other trials involving interferon alpha have proved more encouraging with 20% of patients experiencing a greater than 50% reduction in tumour mass combined with minimal side effects.
The failure of conventional therapies in combating this aggressive tumour has initiated great interest in the development of alternative forms of therapy, especially those capable of specifically destroying diseased cells but not surrounding healthy tissue.