Mesothelioma patients whose T-cell counts bounce back quickly after a round of chemotherapy have a better chance of survival. They are also most likely to benefit from the addition of immunotherapy.
That’s the conclusion of a British study looking for prognostic indicators in mesothelioma patients undergoing a combination of chemotherapy.
hemotherapy is the most common first-line treatment for mesothelioma. It involves flooding the body with a drug or combination of drugs designed to destroy cancer cells. Immunotherapy involves “programming” the immune system to recognize cancer cells as foreign invaders and attack them the way they might attack bacteria or viruses.
To devise a prognostic method for mesothelioma patients who might undergo both types of therapies, the scientists looked for longitudinal changes in peripheral T-cell subsets in 40 patients with malignant mesothelioma or advanced non-small cell lung cancer. All of the patients were receiving platinum-based chemotherapy.
The study found the T-cells of all patients were almost entirely knocked out by the 8th day following chemotherapy, but most bounced back quickly and even passed baseline levels. Regulatory T-cells (Treg) have immunosuppressive properties and are the cells responsible for maintaining order in the immune system. In the study, Treg cells were most profoundly depleted by chemotherapy. Mesothelioma patients whose CD8(+)T-cells bounced back the most after a cycle of chemotherapy had the greatest overall survival. A bigger ratio between CD8(+) T-cell to Treg proliferation was also predictive of better outcomes.
