Immunotherapy
Both studies in animals and clinical trials of immunotherapy suggest that malignant mesothelioma is sensitive to immunotherapy. Trials of interferon alfa, intrapleural interleukin-2, and intratumoral granulocyte–
macrophage colony-stimulating factor have shown some tumor response, but nothing that warrants
widespread use of these agents.
Gene Therapy
Gene therapy for cancer generally involves the administration of engineered viruses to patients. In a small study, six patients with treatment-resistant malignant mesothelioma received intratumoral injections of a vaccinia vector containing the interleukin- 2 transgene in an attempt to modulate the
immune response. This treatment induced a lymphocytic infiltrate and a surprisingly persistent,
though low-level, expression of the transgene, with no major tumor regressions.93 “Suicide gene” therapy
that is, delivery of a viral vector encoding a viral thymidine kinase, which renders the cell sensitive
to the drug ganciclovir by converting the drug to a toxic metabolite has also induced some responses in patients with malignant mesothelioma.
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