Review the traditional treatments of mesothelioma, the innovative treatments, the reasoning behind using radiation therapy, and how many clinical trials are currently being conducted in the US at this point in time.
Traditional treatments are chemotherapy, following surgery which attempts to remove as much of the mass as possible. Chemotherapy is the first line of treatment following surgery. Single agents are no longer used in this disease, as there was less than a 20% responsiveness rate and was considered a poor result. Currently 2 agents are used with increasing response rates to up to as high as 44% survival over one year. Traditional agents are used, but what is of current interest is the novel drug combination of using Bevacitumab and Onconase. Innovative treatment is uisng Alimta (Pemetrexed) for pleural mesothelioma, and using photodynamic therapy (PDT). PDT is a fixed frequency light used to activate photosensitizing drugs that accumulate in body tissues. PDT is administered IV and in a matter of days the durg selectively concentrates in the cancer cells, and is rapidly eliminated by the normal cells. Doctors then use a laser light chosen for its ability to activate the photosensitizing agent using a fiberoptic device to control the laser light. Radiation therapy is used for patients who are not well enough to undergo a surgical procedure, or used in combination with surgery to ease symptoms such as shortness of breath, pain with breathing, or trouble swallowing. Radiation can be given externally to the effected area, or can be placed surgically using radioisotopes which is considered internal radiation therapy. There are currently 11 clinical trials underway in the US, with 16 total clinical trials being conducted worldwide.