Posts Tagged "treatment"


For decades, the future for mesothelioma patients has been bleak. The lung cancer that is related to exposure to asbestos typically affects anyone who worked with or in close quarters with asbestos containing materials. “Shipyard workers and Navy veterans are at a high risk of developing mesothelioma,” says Belluck & Fox, “since many of those individuals lived and worked on navy vessels that asbestos containing materials such as insulation and heating/cooling systems.”

 

On Navy vessels, in particular, the work and living spaces are cramped and ship workers and Navy seamen were likely to breathe in the asbestos particles when they moved, fixed or even brushed up against any component that contained asbestos. At the time, basically anytime before the 1970’s, no one really knew of the dangers of being in contact with the cancer causing materials. Unfortunately, the damage that asbestos causes doesn’t appear until decades later when individuals find out they have an aggressive form of lung cancer and often times, there’s little that can be done.

Promising New Drugs

 

Up until recently, the only available treatments for mesothelioma was surgery, chemotherapy, and radiation, and even those have had less than promising results. Many patients opt for treatment in hopes of relieving some of the pain, while others (doubtful of any hope) reject treatment of any kind.

 

In October of 2015, the U.S. Food and Drug Administration (FDA) approved two new immunotherapy drugs, Keytruda and Opdivo, to be used to fight malignant pleural mesothelioma (or the mesothelioma that affects the lungs). Both drugs were currently used to treat and fight other forms of cancers, but seemed promising for mesothelioma patients with the shortest rates of survival.

 

Keytruda and Opdivo target PD-1 and PD-L1, specific proteins that block an immune system from attacking cancer cells, these proteins were found in patients with aggressive forms of mesothelioma and who had been given the shortest survival time.

How It’s Being Used in Treatment

 

While each drug has shown promising results when used on its own, Keytruda and Opdivo are most effective when used with other drugs as secondary treatment in eliminating any remaining cancer cells after surgery, for example.

 

Since mesothelioma and lung cancer are different because of the way that mesothelioma forms in the lungs. Over time, years after asbestos exposure, cancerous masses cover a large area of the lungs and the ability to separate healthy or cancerous cells is almost impossible. Lung cancer on the other hand can occur from many different types of exposures and doesn’t necessarily spread the same way mesothelioma does. Despite the differences, researchers are confident that Keytruda and Opdivo, with their immunotherapy capabilities, will start to make small changes and hope for mesothelioma patients who have wanted assuming that there’s little option of survival.
While some individuals with mesothelioma may not be recommended for treatment using Keytruda or Opdivo, it may be particularly promising and hopeful for individuals who have otherwise been given a small window of survival. As with all cancer treatments, nothing is guaranteed, but after years of little promise, Keytruda and Opdivo may just be the key to stopping mesothelioma from spreading.

Read More

The Pitfalls of the Traditional Model

For years, Western medicine has taken an imprecise approach to new drugs: Test new drugs on as large a group as possible in a clinical trial, and if enough of those participants benefit, make the drug available to the general public. Sure, this wide-cast net may not help everyone, goes the theory, but with such large numbers, it’s bound to catch a fair number. Plus, it appears efficient, as it deals with thousands of patients with a single trial and a single drug. However, medical professionals are beginning to remark on the flaws in this system.

Even drugs that pass rigorous clinical trials may help surprisingly few patients: the top ten highest-grossing drugs in the US only help between 1/4 and 1/25 of the people who take them. These disappointing figures are exacerbated by the fact that clinical trials disproportionately enlist white participants, whose responses to given drugs are not necessarily identical to other ethnicities’ responses. Trials also tend to focus heavily on chemical analyses to the point of ignoring genetic and environmental factors that play an important role in medication.

Moving Towards Personalized Medicine

Perhaps, it’s time to explore a “precision” approach. Generally, this model means taking into account more factors that affect individuals’ responsiveness to drugs. It may even involve ultra-personalized, one-person studies. In these, the participant would test out a drug, and be tracked in a detailed way over a long period of time, with attention given to genetic and environmental factors. The story wouldn’t end with studying a single person; the results of all these trials together would be aggregated to yield information that is predictive for members of the wider population. By using patterns found in the aggregate data, doctors may be able to more accurately predict how well a treatment will work for a given subset of the population.

Of course, there are significant barriers to the use of one-person studies, chief among them cost. Tailoring trials to individuals tends to cost more than running a broad, one-size-fits all study. Nonetheless, this new model seems slowly to be gaining traction. In January 2015, President Obama announced that he would seek $215 million for the Precision Medicine Initiative, which proposes to use patients’ specific genetic and physiological characteristics to better treat them. Of this, the FDA would receive $10 million to build personalized-medicine databases and to examine its regulatory processes for personalized treatments. Following suit, this year the state of California also unveiled a $3 million precision-medicine project to investigate personalized treatments and diagnoses. As time goes on, we may see a real paradigm shift in how doctors study and treat patients, to understand them as unique individuals whose data points reveal truths about the wider population, rather than the other way around.

Read More