We have heard this story from our patients over and over again: after their diagnosis, the patient and their family are catapulted into an intensive search for treatment options and information. Suddenly, folks with little or no medical background find themselves reading medical literature and searching through clinical trial descriptions. While we hope that our coverage of treatment options and advances helps patients make important decisions, we understand that much of the information presented is often complicated and made more so by the technical nature of the mesothelioma jargon.
For this reason, in conjunction with our recent release of the MesoTV episode titled “Current trends in mesothelioma treatment – discussion by thought-leaders in this disease” we have compiled below, in one place, some mesothelioma jargon terms along with their lay definitions, to make the information in the episode easier to understand.
While we simplify these terms to make them as easy to understand as possible, please be reminded that cancer treatment is incredibly complex and nuanced. If you need any help understanding your diagnosis and treatment, please contact the Mesothelioma Applied Research Foundation (contact info available at www.curemeso.org).
Anti-angiogenesis = inhibition of blood vessel growth with goal of starving the tumor of blood flow
Bev = short for bevacizumab, drug that inhibits the growth of blood vessels (inhibitor of VEGF-A which stands for vascular endothelial growth factor A), also known as anti-angiogenesis or angiogenesis inhibitor agent; has been studied in mesothelioma in combination with pemetrexed/cisplatin; see MAPS study below
Biphasic = cellular type of mesothelioma determined by histologic analysis to contain both epithelioid type cells and sarcomatoid type cells
Cis = stands for cisplatin, a platinum-based chemotherapy most often used in combination with pemetrexed, which in turn is known by brand name Alimta
Carbo = stands for carboplatin, a platinum-based chemotherapy drug, sometimes used in combination with Alimta (pemtrexed) particularly when cisplatin is not well tolerated
Checkmate 743 = a phase 3, randomized study of 713 patients that compared a group of patients treated with combination nivolumab/ipilimumab (combination of two immunotherapy agents) to patients treated with standard platinum + pemetrexed chemotherapy; the study showed a significant improvement in survival among the group treated with immunotherapy and led to the October 2020 FDA-approval of combination nivolumab/ipilimumab for mesothelioma treatment
Doublet = treatment combination of pemetrexed / platinum chemo
Durvalumab = immunotherapy agent that blocks PD-L1 from binding to PD-1, known as a checkpoint inhibitor; currently used in randomized, phase 3 trial of combination chemotherapy/immunotherapy
Epithelioid = cell type in mesothelioma, determined by histology, less aggressive as compared to sarcomatoid; 78% of mesothelioma patients present with this type
Gemcitabine = chemotherapy drug; used in mesothelioma when pemetrexed is not suitable, often in combination with a platinum agent
IO = immunotherapy
Ipi = short for ipilimumab, immunotherapy drug that interrupts the CTLA-4 receptor thus enabling the immune system to attack the tumor
MAPS study = randomized, phased 3 study of combination pemetrexed/cisplatin/bevacizumab that found that the triplet combination improved survival over doublet combination, however with additional toxicity
Nivo = short for nivolumab, immunotherapy agent that blocks the PD-1 protein from binding to the PD-L1 protein, also known as immune checkpoint blockade, allows the immune system to attack the tumor cell
PD-1 = a protein found on the surface of t-cells, stands for programmed cell death protein 1. When connected to the PD-L1, it suppresses the immune system. Utilizing a PD-1 or PD-L1 inhibitor drug, prevents the two proteins from binding (connecting), thereby removing the suppression (brakes) from the immune system allowing it to attack the tumor.
PD-L1 = a protein found on the t-cells, when connected to PD-1, it suppresses the immune system
PD1, PDL1 expression = does the tumor express these proteins and in what quantities?
PD1, PDL1 inhibitors = a class of immunotherapy drugs that inhibit the ability of the PD-1 and PD-L1 to connect to one another thereby allowing the body’s own t-cell to attack the tumor
Pembrolizumab = immunotherapy agent that, also known by its brand name Keytruda, blocks PD-1 receptor from binding to PD-L1
Pemetrexed = also known as Alimta, chemotherapy drug approved by the FDA for mesothelioma in combination with cisplatin
Platinum = platinum-based chemotherapy agents such as cisplatin or carboplatin
Ramucirumab = anti-angiogenesis drug, similar in activity to bevacizumab, but instead of inhibiting only the VEGF-A, it inhibits all VEGFs, therefore with a different benefit vs. toxicity profile
Sarcomatoid = cell type in mesothelioma, as opposed to epithelioid, is considered more aggressive
Significant = statistical term used in studies to convey that an occurrence in the study was tested and shown statistically to not have been random; the term itself does not convey quantifiable benefit – the actual statistics in the study do that (overall survival statistics, progression-free survival statistics, etc.)
Triplet = treatment combination of pemetrexed / platinum-based chemo / bevacizumab
If there are any topics regarding mesothelioma that you’d like us to breakdown and explain better, please contact us at [email protected].
