Malignant pleural mesothelioma is a type of cancer of the lungs caused mostly by exposure to asbestos. When asbestos fibres are inhaled, they can cause tumours to grow in the pleura, the thin membrane of cells (mesothelium) that line the lungs and chest wall. The disease is five times more common in men than women, and occurs between the ages of 60 and 79 years because there is typically a time lag of decades between asbestos exposure and when the disease occurs. It is often diagnosed at an advanced stage and the prognosis is usually poor. People with malignant pleural mesothelioma often have symptoms and respiratory problems such as breathlessness, cough, and fluid on the lungs, as well as chest pain. As the disease progresses, more general symptoms such as tiredness, excessive sweating, weight loss, loss of appetite and difficulty in swallowing become common.
Listeria monocytogenes vaccine is under development for patients who have progressive disease, have had previous chemotherapy and for whom surgery is unsuitable. In current treatment pathways the aim is often symptom management rather than tumour removal, so this drug represents a novel treatment approach for patients who are unsuitable for surgery. The drug aims to help to improve symptoms and has the potential to be well-tolerated by many patients.
Pembrolizumab is an immunomodulatory medicinal product, meaning that it helps the immune system to recognise and attack cancer cells. It is administered by intravenous infusion and is currently licensed in the UK for melanoma, non-small cell lung cancer and urothelial cancer – amongst others. If licensed, pembrolizumab, in addition to chemotherapy, would offer an alternative treatment for those with advanced, recurrent or metastatic cervical cancer.