A cancer research group has identified a molecule that lowers levels of mesothelin (MSLN). The single microRNA molecule, MiR-21-5p, reduced production of malignant pleural mesothelioma (MPM) cell lines. The researchers concluded that, “MiR-21-5p is suggested as novel regulator of MSLN with a possible functional role in cellular growth.” The hope is that, with further study and development, MiR-21-5p could potentially be used in combination with other MPM treatment protocols to lower levels of MSLN, thus slowing the progression of the disease.
Current standard treatment protocols for malignant pleural mesothelioma include surgical intervention, chemotherapy, radiation therapy, and trimodality therapy. Trimodality therapy is a triple combination of chemotherapy, radiation therapy, and surgery. Chemotherapy works by stopping the growth of cancer cells, which divide quickly. It is used to cure cancer, lessen the chance it will return, or stop or show its growth. Chemotherapy is also used to shrink tumors that are causing pain and other problems.
Chemotherapy can be administered orally in pill form, intravenously (into a vein), or injected into a muscle (intramuscular), a body cavity, or into the spinal fluid (intrathecal). Common chemotherapy drugs for the treatment of MPM include Pemetrexed (Alimta), Cisplatin (Platinol and Platinol-AQ), and Gemcitabine (Gemzar).
Radiation therapy uses beams of intense energy to kill cancer cells. Radiation therapy most often gets its power from X-rays, but the power can also come from protons or other types of energy. The two most common surgical procedures for malignant mesothelioma are extrapleural pneumonectomy (EPP) and pleurectomy with decortication.
Extrapleural pneumonectomy involves dissection of the parietal pleura and division of the pulmonary vessels, as well as en bloc resection of the lung, pleura, pericardium, and diaphragm, followed by reconstruction. Pleurectomy with decortication is a more limited procedure than EPP, and requires less cardiorespiratory reserve. It involves dissection of the parietal pleura, incision of the parietal pleura, and decortication of the visceral pleura, followed by reconstruction. This procedure has a morbidity of 25% and a mortality of 2%.
Though these common cancer treatments are the first line of defense against mesothelioma, hundreds of alternative drugs, therapies, and treatments are currently being studied. Some have been successful, while others show great promise.
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