Treatment regimens involving immunotherapy have yielded variable results. For example, intrapleural inoculation of
Bacillus Calmette-Guérin
(BCG) in an attempt to boost the immune response, was found to be of no
benefit to the patient (while it may benefit patients with
bladder cancer). Mesothelioma cells proved susceptible to in vitro lysis by LAK cells following activation by
interleukin-2
(IL-2), but patients undergoing this particular therapy experienced
major side effects. Indeed, this trial was suspended in view of the
unacceptably high levels of IL-2 toxicity and the severity of side
effects such as fever and cachexia. Nonetheless, other trials involving
interferon alpha have proved more encouraging with 20% of patients
experiencing a greater than 50% reduction in tumor mass combined with
minimal side effects.
Heated intraoperative intraperitoneal chemotherapy
A procedure known as heated intraoperative intraperitoneal
chemotherapy was developed by Paul Sugarbaker at the Washington Cancer
Institute.
[36]
The surgeon removes as much of the tumor as possible followed by the
direct administration of a chemotherapy agent, heated to between 40 and
48°C, in the abdomen. The fluid is perfused for 60 to 120 minutes and
then drained.
This technique permits the administration of high concentrations of
selected drugs into the abdominal and pelvic surfaces. Heating the
chemotherapy treatment increases the penetration of the drugs into
tissues. Also, heating itself damages the malignant cells more than the
normal cells.
This technique is also used in patients with malignant pleural mesothelioma.
[37]
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