Hypofractionated Radiation Believed to Increase the Effectiveness of Immunotherapy in Cancer Treatment  

Most cancer specialists operate under the premise that immunotherapy is the future of cancer care. Yet, clinical trial results have shown that current immunotherapy drugs are inconsistent in their effectiveness of treating aggressive cancers such as mesothelioma.

Mesothelioma is an aggressive and rare cancer directly linked to asbestos exposure, sometimes occurring 20 to 50 years previous. The link between this aggressive and incurable cancer and asbestos exposure was suspected as early as the 1930s when miners, who sustained heavy exposure to asbestos, became sick from a not-yet-identified disease.

Since asbestos is a naturally-occurring mineral that is fire and heat resistant, strong, inexpensive and plentiful, it was also used plentifully by the Armed Services as a building material and as an insulator. Until the link between asbestos and cancer was officially recognized, soldiers from across the military branches were exposed to the toxin. Navy veterans, shipyard workers and soldiers in the air force were just some of the military personnel who were exposed to asbestos as they used it to build their base housing and in many other capacities. According to the Vogelzang Law which represents mesothelioma patients, military veterans comprise more than 30 percent of the approximately 2,500 diagnosed mesothelioma cases in the United States each year.

With 29,639 people in the United States having died of mesothelioma from 1999 -2010, researchers have been focused on finding an effective treatment for the disease. Clinical trials have indicated that immunotherapy drugs may offer effective treatment. Immunotherapy uses a cancer patient’s own immune system to combat the spread of cancer and works by stimulating the immune system to work harder or more efficiently to battle cancer.

However, the effectiveness of immunotherapy drugs such as Keytruda (pembrolizumab), Opdivo (nivolumab), Yervoy (ipilimumab) and Tecentriq (atezolizumab) has been inconsistent and hard to predict in trials. As such, researchers have begun experimenting with using boosting agents to increase the effectiveness of the drugs. Doctors at the Princess Margaret Cancer Center in Toronto are now studying the use of hypofractionated radiation to increase the effectiveness of immunotherapy for patients with mesothelioma.

Dr. Marc de Perrot of Toronto General Hospital, the lead author of an editorial published by the Journal of Thoracic Disease, is optimistic and suggests that the synergy of radiation and immunotherapy could become the future standard of care for mesothelioma cancer patients. He writes, “The combination of non-ablative hypofractionated radiation with targeted immunotherapy is a promising strategy for the near future in mesothelioma.”