For Malignant Pleural Mesothelioma, a Therapeutic Route Is Underway

For Malignant Pleural Mesothelioma, a Therapeutic Route Is Underway

In a recent study published in the journal Annals of Translational Medicine, Andrea Viti and colleagues from the Thoracic Surgery Unit, Sacro Cuore-Don Calabria Research Hospital, in Italy, discussed the current, and increasingly promising, state of biological and gene therapy for the treatment of mesothelioma.

Mesothelioma (or, more precisely, malignant mesothelioma) is a rare cancer that develops from cells of the mesothelium, the protective lining that covers many of the internal organs of the body. Mesothelioma is most commonly caused by exposure to asbestos and has no cure.

In recent years, immunotherapy has become an important tool in the treatment of advanced-stage pleural mesothelioma, especially as a second-line therapy.

Gene activation is meant to induce programmed cell death by introducing a specific gene to the target cell, this gene encoding a specific protein with anticancer activity.

Active immunotherapy tries to induce an active response of the immune system, whose surveillance may be easily dodged by cancer cells. In fact, this mechanism seems to play an important role in the development, growth, and diffusion of malignant mesothelioma.

In the study titled “Biologic therapy and gene therapy in the multimodality treatment of malignant pleural mesothelioma,” a team of researchers noted that the development of experimental mesothelioma models — either with the aim of harnessing the activation of a specific immune response or introducing a gene with anticancer activity — has shown promising results in terms of both tumor burden reduction and survival.

Furthermore, the researchers explained that a possible synergic action with cytoreductive surgery has been clearly proven, resulting in a promising application of those “alternative” biologic therapies in the multimodality treatment of mesothelioma.

At the same time, those models have unravelled the complexity of the interaction between the tumor and the immune system, depicting the peritumoral environment as a highly active milieu, where many different type of immune cells act in a both antineoplastic and pro-neoplastic way.

“Mesothelioma displays a powerful ‘anti-immune’ activity, fostered by myeloid-derived suppressor cells, macrophages and CD4+ cells. A thorough understanding of the immunologic landscape housing the tumor will certainly help us develop tailored treatments with lesser side effects than those already observed in the clinical setting. The acquired knowledge will then form the basis for the combination of immune therapy with other approaches, in particular with surgery,” the researchers concluded.


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