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

Our plain-English summary of What's the place of immunotherapy in malignant mesothelioma treatments?, by M. Grégoire (Cell Adhesion & Migration, 2010).

The study

• Author: M. Grégoire
• Journal: Cell Adhesion & Migration
• Published: 2010;4(1):153-61
• Type of article: Review
• Cited by: 24 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

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.

In plain English

This article by Marc Grégoire is a narrative review, not a new study. The author reviewed research on immunotherapy (treatments that help the immune system attack the tumor) for malignant mesothelioma, including the author's own laboratory work. It covered cytokines such as interleukin-2 and interferons, gene therapy, drugs aimed at the protein mesothelin, dendritic-cell vaccines and cancer-killing viruses. In interleukin-2 trials, median survival was around 8 months for patients whose tumors progressed and 13.6 months for those whose tumors showed an objective response. One trial of interferon gamma plus macrophages, given into the pleural cavity, reported a median survival of 29.2 months in 19 patients. A vaccine trial reported median survival of 11.5 months for all patients and 14.5 months for the 16 of 21 who completed treatment. The author wrote that the passive immunotherapy studies showed the immune system could respond, but gave no real evidence of a treatment benefit. No immunotherapy had yet been validated, the author added. The author concluded that mesothelioma should be the subject of several cellular immunotherapy trials in the near future.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Narrative review of published preclinical and clinical studies of immunotherapy for malignant mesothelioma. It also includes some laboratory work by the author's own group.
• Who was studied: No study population of its own. The review covered published studies and trials of immunotherapy in patients with malignant mesothelioma, including the cytokine trials listed in Table 1. It also covered animal and cell-culture studies.
• Exposure: The immunotherapy treatments reviewed were cytokines (interleukin-2, interleukin-12, GM-CSF, and interferons alpha, beta and gamma), gene therapy, anti-mesothelin agents (SS1P, MORAb-009), dendritic-cell vaccines and oncolytic viruses such as measles vaccine virus. The article is not a study of asbestos exposure.
• Main results:
  • In interleukin-2 trials, given mostly into the pleural cavity, the review reported median survival of around 8 months for patients whose tumors progressed. It reported 13.6 months for those with an objective response.
  • In the trial by Monnet et al., interferon gamma plus macrophages was given into the pleural cavity for 8 weeks. The review reported a median survival of 29.2 months for the 19 patients treated.
  • In the same Monnet et al. trial, the review noted that 10 of 17 treated patients were later able to receive a course of chemotherapy.
  • In the interferon gamma trial by Boutin et al., carried out at an early stage of the disease, the review reported objective efficacy above 20%. This included a complete, histologically confirmed response in eight patients.
  • In the phase I trial from Robinson's group (GM-CSF plus autologous tumor lysates), 16 of 21 patients completed treatment. Median survival was 11.5 months for all patients and 14.5 months for the 16 who completed treatment. The author described this as only slightly better, if at all, than survival after chemotherapy.
  • In the phase I trial of the anti-mesothelin agent SS1P, 34 patients were included, 21 of them with mesothelioma. Among the patients included, 4 had partial responses and 19 had stable disease.
  • The author summarized the passive immunotherapy studies as showing that patients' immune systems could respond, but without real evidence of a therapeutic benefit.
  • The author stated that, at the time of writing, no immunotherapy had been validated for efficient treatment of mesothelioma.
• The authors' conclusion: The author concluded that mesothelioma should be the subject of several cellular immunotherapy trials in the near future. The author based this on the immune cell findings in mesothelioma patients and the easy access to the tumor within the pleural (or peritoneal) cavity.
• Limitations the authors state:
  • The author noted that the results of the vaccine studies pointed more toward an immune response than toward an objective response of the tumor to treatment.
  • The author noted that studies of the immune status of mesothelioma patients are infrequent and rarely discussed.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Immunotherapy, Mesothelioma, Pleural Mesothelioma, Pleura, Prognosis, Chemotherapy.

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• Immunotherapy for Treatment of Pleural Mesothelioma: Current and Emerging Therapeutic Strategies — L. Chiec, D.S. Bruno (2024)
• Multimodality treatment of malignant pleural mesothelioma with or without immunotherapy: does it change anything? — M. Lucchi, A. Picchi, et al. (2010)
• Fractionated low-dose radiotherapy primes the tumor microenvironment for immunotherapy in a murine mesothelioma model — R.A. D'Alonzo, S. Keam, et al. (2025)
• Is there a role for immunotherapy in malignant pleural mesothelioma? — A. Tartarone, R. Lerose, et al. (2018)
• An appropriate choice for immunotherapy in malignant pleural mesothelioma — N. Fujimoto (2020)

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