2021 Mesothelioma Advances | Progress Despite COVID-19

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A recent study combined CAR T-cell therapy with pembrolizumab (Keytruda®), a checkpoint inhibitor. The combination was used as a second-line treatment for pleural mesothelioma. Researchers combined these treatments in an effort to overcome perceived shortcomings of CAR T cells. Patients receiving this treatment had a median survival of two years. This is about one year longer than previous second-line treatments.

Given these positive results, researchers may continue performing studies of this combination. If the FDA approves it, it will be more accessible. Until then, eligible patients may access this treatment through clinical trials.

New Research on Surgery for Mesothelioma

For decades, surgery has been a prominent mesothelioma treatment. In 2021, researchers continued studying surgical options for peritoneal and pleural mesothelioma. Ongoing research led to notable advances in several surgery methods. These include Hyperthermic Intraperitoneal Chemotherapy (HIPEC), extrapleural pneumonectomy and pleurectomy/decortication.

Repeat CRS + HIPEC May Extend Peritoneal Mesothelioma Survival

There are promising studies for treating peritoneal mesothelioma with combination, or multimodal, treatments. One such study analyzed cytoreductive surgery (CRS) combined with HIPEC therapy. This study showed patient survival may improve with several rounds of CRS and HIPEC.

CRS and HIPEC treatment combines surgery with local, heated chemotherapy. Patients who received one round of this treatment had a median survival of 27.2 months. In comparison, those who received repeat rounds had a median survival of 80 months.

Improved median survival may increase interest in this treatment. There are many factors to consider before pursuing repeat CRS and/or HIPEC. Peritoneal mesothelioma patients should discuss treatment options with their doctor.

Pleurectomy/Decortication (P/D) vs. Extrapleural Pneumonectomy for Pleural Mesothelioma

A 2021 study reviewed 20 years’ worth of surgical procedures for pleural mesothelioma. All 282 surgeries used one of the two pleural mesothelioma surgery methods:

  • Pleurectomy and Decortication (P/D): a surgery that removes mesothelioma tumors
  • Extrapleural Pneumonectomy (EPP): a surgery that removes mesothelioma tumors and the affected lung

Researchers documented many details of disease, recovery and quality of life. Findings showed that with all factors considered, P/D was the more successful surgery.