Mesothelioma is a form of cancer that is directly correlated with exposure to asbestos and is diagnosed in the lining of the lungs, abdomen and heart. Symptoms of mesothelioma take a prolonged period of time to develop, and by the time they do arise, this cancer has likely progressed to a later stage. Treatment for this disease has proven to be difficult, as patients not only face a poor life expectancy, but the demographic of this cancer is most commonly found to affect adults 65 years and older. However, a new form of treatment known as CAR-T cell therapy has been making waves in the field of oncology, and clinical trials have begun for patients with Malignant Pleural Mesothelioma (MPM).

What Is CAR-T Cell Therapy?

CAR-T cell therapy is the reengineering of a patient’s immune cells to target cancer cells. Known as “T cells,” these type of white blood cells are a major part of our body’s ability to target infections within our immune system. The process of CAR-T cell therapy starts with the removal of T cells from a patient’s bloodstream. These T cells are then given a gene for a specialized receptor known as a chimeric antigen receptor (CAR). These new engineered cells then multiply and are able to specifically target and attack the patient’s cancer cells, leaving their healthy cells unharmed. This treatment is also catered specifically to the patient, meaning that T cells that are engineered for a patient who has mesothelioma will not work for a patient who has leukemia. After there is an ample amount of new T cells created, they are infused back into the patient’s bloodstream.

When these T cells re-enter the body, the patient must be closely monitored for potential side effects. While nausea, rash, and headaches are typical in someone undergoing CAR-T cell therapy, there could be other more serious issues lurking. When T cells begin to propagate, or a significant number of these cells are infused, large abundances of cytokines can be released, leading to dangerously high fevers and a decrease in blood pressure. This is known as cytokine release syndrome (CRS). In severe cases, CRS can cause the brain to swell (cerebral edema), which can be fatal. While there are serious, potentially deadly side effects, patients are lining up to enroll in clinical trials for CAR-T cell therapy.

CAR-T Cell Therapy And Mesothelioma

In March of 2019, researchers from Memorial Sloan Kettering Cancer Center (MSKCC) presented their updated findings of clinical trial work they have been conducting in regards to CAR-T cell therapy and mesothelioma patients. Headed by Dr. Prasad Adusumilli, the Phase I clinical trial showed tumor reduction in patients who participated and no evidence of toxicity. This trial consisted of 21 patients, 19 of which had MPM. All 21 patients received a single dose of CAR-T cells directly into the chest cavity. 13 patients had presence of CAR-T cells in their bloodstream after several months, with signs of antitumor activity. One patient with MPM was able to undergo curative-intent surgery and is now 20 months post-diagnosis and has not had to withstand any further treatment.

Mesothelioma Awareness Day

The 17th anniversary of Mesothelioma Awareness Day is on September 26th. Discussing new treatments and advances in the community will continue to spread awareness about this rare cancer and asbestos exposure. With mesothelioma being linked directly to asbestos, we have the ability to never see a mesothelioma diagnosis again. However, this will only be possible if a global asbestos ban is enacted and further legislation is pushed to mitigate exposure.