New Clinical Trial Significantly Improves Survival Rate in Mesothelioma Patients 

A group of transnational medical scientists found an innovative treatment that could significantly improve the survival rate of people with pleural mesothelioma. The study published earlier this year in JAMA Oncology presents a trial study of the novel cancer chemotherapy called pegargiminase-chemotherapy. The therapy was successfully applied to treat patients with nonepithelioid pleural mesothelioma, a malignant tumor that attacks the lungs. This is a significant medical achievement in the field of cancer research. Besides providing a good lead for scientists working towards understanding this life-threatening disease, it might give hope to millions suffering from mesothelioma.  

Mesothelioma is an aggressive cancer caused by contamination resulting from prolonged exposure to toxic asbestos. The tumor develops when the membrane lining the lungs, heart, chest cavity, gastrointestinal system, and reproductive organs, called the mesothelium, is attacked by asbestos. This toxic contaminant is a strong, heat-resistant mineral fiber found in rock and soil. It was used for its fire-resistant and insulating properties in the United States until the early 1970s, when its adverse health effects, especially carcinogenic nature, started to surface. Even though the use of asbestos has declined substantially since then, several types of imported asbestos are still used in the U.S., mainly in construction materials. In March of this year, the Environmental Protection Agency (EPA) banned chrysotile asbestos, the most common form of it. 

The numbers are worrying  

The number of people diagnosed with mesothelioma since the 1960s is on the rise year by year. That is because of the long latency period of mesothelioma. As the symptoms can take from 10 to 50 years to show, workers exposed to asbestos in the 1960s and 1970s are now diagnosed with asbestos-associated diseases, such as lung cancer, asbestosis, and the almost always fatal mesothelioma. Those primarily affected are construction workers, industrial workers, and military veterans who worked in the construction, shipbuilding, and automotive industries with cement pipes, clutches, brakes, transmission components, roofing products, coatings, and insulation materials. Whether in use or not, asbestos remains in many buildings, ships, and automobiles built in the past decades and endangers those in contact with it. People can even be exposed to asbestos at home if they renovate their houses.  

People are at risk of inhaling asbestos fibers when asbestos-containing material (ACMs) is disturbed or damaged, and the small mineral fibers are dispersed in the air. The EPA and the International Agency for Research on Cancer agree that all types of asbestos fibers settled in the upper and lower respiratory tracts are carcinogenic. National data shows that approximately 27 million people were exposed to asbestos between the 1940s and 1970s. The most affected are those working in construction who are in regular contact with asbestos. Another greatly affected population is military service members, as the military, especially The Navy in its shipyards and ships, used large quantities of ACMs for decades. Their family members suffer, too, from the adverse effects of asbestos, as secondary exposure can be as dangerous as direct exposure. The consequences are devastating. Statistics show that asbestos-related illnesses have caused the death of many already, and the numbers have been on the rise for the past several decades.  

The Environmental Working Group (EWG), based on data from the U.S. Centers for Disease Control and Prevention, estimates that from 1999 to 2013, as many as 12,000 to 15,000 Americans died every year from diseases stemming from asbestos exposure, from which the number of mesothelioma deaths was about 2,848 a year. A more comprehensive study of asbestos-caused deaths released by The Institute for Health Metrics and Evaluation (IHME) shows a sharp increase compared to the previous estimates by the EWG. According to the IHME, 40,764 Americans died from asbestos-related diseases in 2019.  

A scientific breakthrough and its significance  

The number of mesothelioma patients in the U.S. is constantly rising. Worryingly, the number of those who lose their lives to this horrible disease is also growing, as mesothelioma tends to be hard to treat. Whether the tumor can be removed or not usually depends on the stage of mesothelioma when it is diagnosed, on the subtype of mesothelioma (the most common type is pleural mesothelioma, when it forms around the lungs, but it can develop around the heart, in the abdomen or around the testicles), and if the person is healthy enough to have surgery. As stage 4 mesothelioma and many earlier stage ones cannot be removed, chemotherapy is the only option, but the survival rates are low.  

Besides the difficulty of treating it, mesothelioma is often misdiagnosed since the symptoms are similar to many other health problems. The incorrect estimation of the stage of mesothelioma can be as negative as a misdiagnosis. A medical study highlights that, generally, about half of pleural mesothelioma patients receive incorrect disease stage diagnostics, meaning that the illness is only detected at a later stage when the only treatment option is chemotherapy.       

These details highlight the importance of the aforementioned clinical trial study testing pegargiminase-chemotherapy. The tests were conducted at 43 centers in 5 countries with 249 nonepithelioid pleural mesothelioma patients for 4 years, between August 2017 and August 2021. According to the results, this novel chemotherapy was well tolerated, increasing the patients' median survival by 1.6 months and quadrupling the survival at 36 months compared to placebo chemotherapy.  

While more time and effort must be invested into the clinical testing of pegargiminase-based chemotherapy, it is worth all the resources. Our country has already failed millions of people who have suffered or are currently struggling with mesothelioma. Most manufacturers knew of the dangers of asbestos and kept it a secret. By the time the information about the carcinogenic nature of asbestos came to light in the early 1980s, it was too late. Our policymakers not only allowed irresponsible manufacturers to produce this toxic substance but were too late to take significant actions toward banning it. What we can do now is to raise awareness about the dangers of asbestos, to support those who might have been affected, and to advocate for finding better treatment options for our veterans, construction workers, and everyone living with mesothelioma.      

About the author 

Jonathan Sharp is a Chief Financial Officer at Environmental Litigation Group, P.C. The law firm, based in Birmingham, Alabama, specializes in toxic exposure cases.  

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