Traditionally, mesothelioma is associated with very few treatment options. However, the US Food and Drug Administration has approved certain standards of care that could streamline new mesothelioma treatments and help with affecting prognosis in a positive way. Over the past couple of years there have been advances in radiology, surgery, radiation, medical oncology, and chromothripsis. Chromothripsis is a process in which thousands of clustered chromosomal rearrangements take place in a single event in localized and confined regions in one or a couple chromosomes. There have also been advances in potential T-cell therapies for new mesothelioma treatments.
Genes
BAP1 is the gene that is mutated most in mesothelioma. Through an advanced technique it was found that BAP1 is commonly affected by chromothripsis, which I described earlier. In other words, chromothripsis takes place due to “numerous double-strand breaks of a large segment of a chromosome or a whole chromosome that has been likened to the shattering of a chromosome.” Fixing these breaks in chromosomes causes many rearrangements and copy-number changes. Evidence for chromothripsis in mesothelioma was seen in a study of 22 specimens, in which 1,535 chromosomal rearrangements were seen. Understanding this whole process better could result in new mesothelioma treatments.
Imaging Tests to Determine New Mesothelioma Treatments
A CT scan is normally used to determine if someone has mesothelioma, particularly with pleural mesothelioma, which originates in the lining of the lungs. CT scans can detect pleural thickening, pleural plaques, and pleural effusion – which are all evidence of the effects of asbestos in the lungs.
Metabolic imaging is used to determine the extent of the mesothelioma, particularly in those in which resection, or complete removal of the tumor by surgery, may be an option. An MRI is frequently used to look at the chest wall and over the past couple of years diffusion-weighted MRI has been investigated to determine if the disease is malignant or not.
New Mesothelioma Treatments in Surgery
When it comes to surgery for mesothelioma, the goal is complete resection. When it comes to new mesothelioma treatments, pleurectomy decortication or extended pleurectomy decortication has widely replaced the standard of an extrapleural pneumonectomy (EPP). This is most likely because pleurectomy is associated with lower mortality and morbidity when compared to EPP. Although you may think surgery is the ideal treatment option, sometimes planned surgeries do not take place due to the patient’s physical condition. Only 60 percent to 80 percent of patients that are supposed to undergo surgery will end up getting that surgery.
Radiation Therapy
Radiotherapy can be administered in a multitude of different ways when it comes to treating mesothelioma. It can be used in the adjuvant, neoadjuvant, and palliative settings. When malignant pleural mesothelioma is in the early stages, radiotherapy is usually delivered to the hemithorax either before or after surgery. For new mesothelioma treatments, it is better to use newer methods of radiation therapy to keep damage to the surrounding tissue at a minimum.
When a patient has surgically resectable mesothelioma, there is a good chance that they will get four cycles of neoadjuvant or adjuvant cisplatin-pemetrexed therapy.
In all, over the past couple of years, there has been more research done on mesothelioma in general as well as different approaches to new mesothelioma treatments that could be useful and could help prolong the lives of mesothelioma victims.
If you or a loved one has been diagnosed with mesothelioma or another asbestos-related disease, please call (800) 505-6000. We are here to provide you with information and legal help. To learn more, fill out our form.
Sources:
https://www.sciencedirect.com/topics/medicine-and-dentistry/chromothripsishttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8853621/
