In spite of a global pandemic, there were some major breakthroughs in mesothelioma in 2020 that made the year a hopeful one for people fighting asbestos cancer.

Malignant mesothelioma is the most serious illness caused by exposure to asbestos fibers.

Mesothelioma is still not curable. But researchers have made major breakthroughs in mesothelioma diagnosis, prognosis, and treatment this year.

Mesothelioma treatment saw the biggest breakthroughs in mesothelioma in 2020. The FDA approved the first systemic treatment for mesothelioma since 2004. That was the year that Alimta (pemetrexed) received approval.

They approved a combination of the immunotherapy drugs Opdivo and Yervoy. Yervoy helps activate and proliferate T-cells. Opdivo helps existing T-cells discover the mesothelioma tumor. The patients who got the new drug combination for mesothelioma lived a median of 18 months.

At one year, almost 70 percent of patients who got the immunotherapy drugs were still alive. Only 58 percent of chemotherapy patients lived that long.

The second most important of the breakthroughs in mesothelioma treatment this year centers on Tumor Treating Fields. The electrical device received a new name in 2020. It is now Optune Lua. Optune Lua interrupts the replication of mesothelioma cells and stimulates the immune system.

This summer, the makers of Optune Lua and the immunotherapy drug Keytruda announced that they are teaming up for a new study. The study is testing a combination of these treatments in non-small cell lung cancer patients. The results are likely to impact the future of mesothelioma treatment, too.

One of the most significant breakthroughs in mesothelioma diagnosis was a biomarker study in July. That study appeared to confirm the best biomarkers for mesothelioma diagnosis and prognosis.

Two of the countrys top authorities on mesothelioma, Dr. Harvey Pass of New Yorks Langone Medical Center and Dr. Michele Carbone of the University of Hawaii, were authors on the new report.

They conducted a major review of medical literature over the last 20 years. They concluded that SMRPs (Soluble Mesothelin Related Proteins) are the best diagnostic biomarkers for mesothelioma. SMRPs are also the most valuable biomarkers for monitoring the success of mesothelioma treatment.

Other important diagnostic breakthroughs for mesothelioma were two reports on the use of artificial intelligence.

One study came from the Stevens Institute of Technology and the other from Mount Sinai Medical Center in New York. Both suggest that machine learning which can identify patterns that doctors miss may be the future of mesothelioma diagnosis and treatment planning.

International Immunopharmacology published the largest study ever on PD-L1 expression and mesothelioma prognosis. It showed that patients whose cells express more of this protein have lower odds of survival.

Programmed death ligand 1 (PD-L1) helps cancer cells evade immune system attack.

Other studies have suggested a link between PD-L1 expression and mesothelioma prognosis. But a meta-analysis performed by Chinese researchers confirmed it with an even bigger data set.

Another of the breakthroughs in mesothelioma prognosis also centered on protein expression. This time, BAP1 was in the spotlight. Alterations of the BAP1 gene affect BAP1 expression. People with low levels of BAP1 appear to have a higher risk for mesothelioma.

But a large Italian study released in July suggested that mesothelioma prognosis has more to do with subtype than with BAP1 expression. It cautioned doctors not to put too much stock in BAP1 expression without also considering other factors.

Sources:

FDA Approves Drug Combination for Treating Mesothelioma, FDA Press Announcement, October 2, 2020, https://www.fda.gov/news-events/press-announcements/fda-approves-drug-combination-treating-mesothelioma

Novocure Announces Clinical Trial Collaboration with MSD to Evaluate Tumor Treating Fields Together with KEYTRUDA (pembrolizumab) in Non-Small Cell Lung Cancer, July 15, 2020, Novocure Website

Choudhury, A, Predicting cancer using supervised machine learning: Mesothelioma, June 19, 2020, Technology in Health Care, https://content.iospress.com/articles/technology-and-health-care/thc202237

Dumane, VA, et al, RapidPlan for Knowledge-Based Planning of Malignant Pleural Mesothelioma, June 17, 2020, Practical Radiation Oncology, Epub ahead of print, https://www.practicalradonc.org/article/S1879-8500(20)30158-2/pdf

Pass, H, et al, Mesothelioma Biomarkers: A Review Highlighting Contributions from the Early Detection Research Network, July 22, 2020, Cancer Epidemiology, Biomarkers & Prevention, Epub ahead of print, https://cebp.aacrjournals.org/content/early/2020/07/22/1055-9965.EPI-20-0083

Zhang, F, and Gong, W, Prognostic and clinicopathological utility of programmed death-ligand 1 in malignant pleural mesothelioma: A meta-analysis, April 24, 2020, International Immunopharmacology, Epub ahead of print, https://www.sciencedirect.com/science/article/pii/S1567576920306639?via%3Dihub

Cantini, L, et al, Questioning the Prognostic Role of BAP-1 Immunohistochemistry in Malignant Pleural Mesothelioma: A Single Center Experience With Systematic Review and Meta-Analysis, June 21, 2020, Lung Cancer, Epub ahead of print, https://www.lungcancerjournal.info/article/S0169-5002(20)30498-0/pdf

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Breakthroughs in Mesothelioma in 2020 - Surviving Mesothelioma