New Mesothelioma Treatments

In edition 246 of BC Disease News (here), we reported on STELLAR Phase II clinical trial, in which pleural mesothelioma patients received Tumour Treating Fields therapy in combination with chemotherapy. Results surpassed expectations. In this article, we report on additional developments in the field of mesothelioma treatments, including radiofrequency ablation and enhanced radiotherapy.

Radiofrequency Ablation

In Japan, it has been reported that a mesothelioma patient has been treated with radiofrequency ablation.[i] 

Radiofrequency ablation (RFA) uses heat, generated by radio waves, to completely kill cancer cells. A probe is passed through the skin and into the tumour. The electrical current in the probe transfers heat to cancer cells, which destroys them. RFA is often used in combination with other therapies to treat cancers of the liver, lung and kidney. It is often recommended if a patient’s tumour cannot be removed surgically[ii]. Unlike some other cancer treatments, RFA has minimal effects on surrounding tissues.

In the Japanese case, the malignant pleural mesothelioma patient was initially treated with chemotherapy, surgery and radiation therapy. After 2 and a half years, the tumour reappeared.  Surgical removal of the tumour would have been problematic, as a result of previous surgical procedures. Consequently, the patient’s medical team decided to use RFA.

Results of the treatment were ‘excellent’; there were no complications and the size of the tumour reduced significantly.  There was also no further tumour growth or recurrence.[iii]

The research team has said that RFA should be considered a genuine treatment option for mesothelioma patients.

Radiotherapy

Using radiotherapy, tumours are exposed to radiation that damages tumour cells and makes them unable to reproduce.  Radiotherapy can be used in an attempt to destroy the cancer completely, or it can be used to control symptoms, such as pain.  It is often used in combination with other treatments, such as surgery, chemotherapy, hormonal therapy and biological therapy. 

A challenge of radiotherapy is making sure that the radiation only affects the tumour and not the surrounding tissues.  This is particularly difficult in mesothelioma patients because mesothelioma forms a thin layer in an irregular shape and can be close to vital organs, such as the heart and lungs. As a result, radiotherapy has been primarily used to help to treat the symptoms of mesothelioma, rather than as a curative treatment.[iv]

A recent review has suggested that radiotherapy techniques are improving, and that new technologies may allow radiotherapy to become a more useful treatment method for mesothelioma.[v]  The review reports that radiotherapy may be a helpful tool in combination with other treatments, such as surgery and immunotherapy. 

Precise radiotherapy can be used to shrink mesothelioma tumours before surgery, so that they are then easier to remove.  After surgery, treatment with radiotherapy may help to prevent the development of new tumours. 

 

[i]  Nakamura, A. et al. Radiofrequency Ablation Effectively Treated Focal Recurrence of Mesothelioma. Ann. Thorac. Surg. 105, e265–e267 (2018). https://www.ncbi.nlm.nih.gov/pubmed/29410265 (Accessed 26 September 2018)

[ii] Radiofrequency ablation.  Cancer Research UK. https://www.cancerresearchuk.org/about-cancer/cancer-in-general/treatment/other/radiofrequency-ablation (Accessed 26 September 2018)

[iii] Radiofrequency Ablation for Recurrent Mesothelioma:  A New Treatment Option?  Surviving Mesothelioma.com 17 September 2018 https://survivingmesothelioma.com/radiofrequency-ablation-for-recurrent-mesothelioma-a-new-treatment-option/ (Accessed 26 September 2018)

[iv] Radiotherapy likely to play a bigger role in future mesothelioma therapy. Surviving Mesothelioma.com, 15 September 2018. https://survivingmesothelioma.com/radiotherapy-likely-to-play-a-bigger-role-in-future-mesothelioma-therapy/ (Accessed 26 September 2018)

[v] Cramer, G., Simone, C. B., Busch, T. M. & Cengel, K. A. Adjuvant, neoadjuvant, and definitive radiation therapy for malignant pleural mesothelioma. J Thorac Dis 10, S2565–S2573 (2018). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6123183/ (Accessed 27 September 2018)