What's the place of immunotherapy in malignant mesothelioma treatments?

Abstract

Malignant pleural mesothelioma (MPM) is a rare malignancy of the pleura with a very poor prognosis. Treatments evaluated for malignant mesothelioma, including chemotherapy, radiotherapy and surgery are of limited efficacy. However, the fact that the tumors of some patients with MPM regress spontaneously or respond to immunotherapy suggests that the immune system may respond to MPM under some circumstances. In this respect, animal studies have demonstrated immunoreactivity of MPM to different immunotherapies. In the case of MPM, several clinical studies have demonstrated a correlation between the presence of a lymphocyte infiltrate and a better prognosis and humoral response directed against specific antigens related to tumor. Thus, MPM immunotherapy is undoubtedly a highly promising but also very challenging approach to the treatment of this disease that has slipped through the defense lines of the immune system. This article reviews past and recent developments of the clinical strategies that concern immunotherapy of mesothelioma.

Figure 1

Proposal clinical application of immune therapy to treat MPM with dendritic cells loaded with autologous apoptotic tumor cells. The cancer cells can be treated in vivo and in vitro with either chemotherapeutic/immunogenic drugs or infected with the Measles virus vaccine. Part I to III could be proposed before the conventional treatment of the Patient, and part V to X after the treatment, when clinical efficacy is noticed.