Disease of the Month- Mesothelioma

Shots:

To keep our readers acquainted with several disease conditions, ongoing trials, and available treatment options, PharmaShots brings every month a detailed take on a particular disease after thorough research
Continuing the series for the disease of the month, PharmaShots brings a condensed report on Mesothelioma, a type of cancer that affects the lining of the lungs, chest wall, and abdomen

26th September is observed as Mesothelioma Awareness Day, a disease that affects people in every country around the globe

Introduction:[1]

Malignant mesothelioma is a cancer of the thin tissue (mesothelium) that mainly affects the lining of the lungs, chest wall, and abdomen. The major risk factor for mesothelioma is exposure to asbestos fibers which get trapped in the lungs and abdomen and damage the lungs and abdomen over time.

The prognosis of mesothelioma patients undergoing some sort of treatment after Patient Advocacy Groups (PAGs) for Mesothelioma: [10,11,12] diagnosis is about 12 to 21 months (about 2 years) and the current 5-year survival rate for mesothelioma stands at 12%

Mesothelioma is interpreted vaguely as the disease does not show any symptoms until late on and progresses quite quickly once it reaches this stage.

Based on tumor size and location, there are four stages of mesothelioma that doctors have come across and prepared the treatment plans. The stages are:

Tiny tumors develop in mesothelium layer (Stage 1)
Tumors grow and spread to nearby lymph nodes (Stage 2)
Tumor spread to nearby tissues and organs (Stage 3)

Tumor spread to distant organs (Stage 4)

Types of Mesothelioma:

Based on the location of the tumor, Mesothelioma is categorized as:

1- Pleural Mesothelioma: It forms in the lining of the lungs

2- Peritoneal Mesothelioma: Develops in the lining around the abdomen

3- Pericardial Mesothelioma: It develops in the tissue of the heart

4- Testicular Mesothelioma: It forms in the membrane that covers testes

Symptoms:

Chest pain

Shortness of breath
Fatigue (extreme tiredness)
Sweating
Muscle weakness and pain
Cough

Loss of appetite
Weight loss
Clubbed (swollen) fingertips

Diagnosis [3]

The following tests are available to diagnose mesothelioma:

Physical Examination: During a physical examination a doctor will look for abnormalities, such as a bump on the skin, and check parts of the body that feel tender or painful.

Blood Tests: To identify biomarkers of cancer but cannot diagnose the condition alone

Imaging Scans: X-rays, MRIs, and PET scans help spot the location of tumors.

Biopsy: Thoracoscopy or Laparoscopy can be conducted, and tissue samples can be removed for biopsies

Epidemiology: [4,5]

According to NIH, in 2017, around 34,615 new cases of mesothelioma and 29,909 deaths were reported of which more than 70% of these cases and deaths were among male individuals.

According to WHO, in 2020, a total of 30,870 new cases of mesothelioma were registered and 26,278 deaths were reported.

Market Size: [6]

According to Market Research analysis, the global malignant mesothelioma therapeutics market was valued at ~$259.3M in 2022 and is expected to grow up to ~$568.17M by 2032 at a CAGR of 9.0%.

Treatment: [7,8]

As mesothelioma is diagnosed at an advanced stage, the available treatment options are usually palliative or supportive care, focused on controlling the symptoms and improving the quality of life.

Reducing tobacco consumption and smoking.

The treatment options include surgery, chemotherapy, radiation and immunotherapy, and Tumor Treating Fields
Chemotherapy includes the combination of gemcitabine and cisplatin which was approved by the US FDA to treat mesothelioma.
Some immunotherapies are available in the market such as Opdivo + Yervoy (BMS) and Alimta (Eli Lilly)

Key Player in the Market:

Some of the key players in the market are depicted in table:

Clinical Trial Analysis: [9]

Various pharmaceutical companies are working to develop new treatment options, either as monotherapy or in combination for mesothelioma. As of August 31, 2023, about 204 interventional clinical trials were registered worldwide for Mesothelioma. Some of the key molecules involved in the trials are Keytruda (Merck), THOR-707 (Sanofi), IAG933 (Novartis), OT-101 (Oncotelic and Mateon Therapeutics), rAd-IFN (Trizell), INCB099318 (Incyte), etc.
Based on geographical distribution, the interventional and Industry funder type clinical trials are classified in the below-mentioned graph in two groups based on their status i.e., active (recruiting, active, not recruiting, not yet recruiting and enrolling by invitation, suspended) and inactive (withdrawn, terminated and trials with unknown status). A maximum number of active trials is being conducted in the US and France while a minimum of trials was reported in Spain and the UK (as represented in the graph)
Patient Advocacy Groups (PAGs) for Mesothelioma: [10,11,12]

References: