Medical oncologist Dr. Angus Dalgleish never did like standard of care treatment for pleural mesothelioma cancer, even when he reluctantly recommended it in the past.
He believes now there is something better.
Dalgleish, of St. George’s Hospital, University of London, recently published a case report detailing a novel treatment regimen that turned a six-month life expectancy for one patient into a six-year survival.
The treatment involved a series of anti-inflammatories that included low-dose naltrexone, vitamin D3 supplements and the vaccine IMM-101, which heightens a patient’s own immune response.
“Initially, I was pleasantly surprised at how well this worked, but it made good sense,” Dalgleish told The Mesothelioma Center at Asbestos.com. “We’ve seen positive signs with other tumors. This certainly deserves to be looked at much closer with mesothelioma. It could become very important.”
His findings were published in Respiratory Medicine Case Reports.
The case involved a 64-year-old male in the United Kingdom who was diagnosed with epithelioid mesothelioma and pleural effusions, lung nodules and increased thoracic lymph nodes. His original oncologist recommended the aggressive pleurectomy and decortication surgery, along with adjuvant chemotherapy and possibly radiation.
Instead, the patient turned to Dalgleish for guidance.
“He had serious concerns about quality of life issues if he underwent the recommended treatment, and I agreed with him,” Dalgleish said. “Aggressive treatment, sometimes for this disease, is like putting fuel on the fire. I’ve often said, ‘Why are we doing this to patients?’ It’s like going into a room and kicking a sleeping Rottweiler. It doesn’t make sense.”
Dalgleish had seen positive results using the vaccine in combination with chemotherapy as part of a study for pancreatic cancer treatment. It is known as an immune modulator, which boosts a patient’s immune response but also dampens a negative system response.
Dalgleish had done extensive research with other cancers into the benefits of maximizing the anti-inflammatory response. He always believed that common vitamin D3 deficiencies in older patients diminished the effectiveness of cancer treatment.
And he knew about two mesothelioma patients earlier who joined a lung cancer clinical trial studying a similar regimen. They did better than expected.
“I had reason to believe this [regimen] might be effective,” he said. “And it certainly was in this case.”
A year after the patient started the treatment, a CT scan showed no tumor progression, taking him well beyond his initial life expectancy.
Three years later, another CT scan showed slow tumor progression, prompting him to begin taking zoledronic acid, which often is used by cancer patients to combat elevated levels of calcium. He also underwent local radiotherapy for an enlarging chest wall lesion where the original biopsy was performed.
The patient later began taking cannabis oil but took no other treatment drugs. He died in 2019, six years after his original diagnosis.
He died, though, from disease which had migrated into his peritoneal cavity and not from the tumor burden originally found in his chest.
Dalgleish believes there will be other mesothelioma patients willing to bypass standard of care to further study a similar treatment regimen in a clinical trial.
He estimated that one-third of pleural mesothelioma patients in the United Kingdom opt against standard of care because the survival advantage is minimal, and the drop in quality of life it causes is significant.
“There is really nothing out there approved that works well enough that I would be interested in taking,” he said. “It’s very marginal and quite toxic. Why not try something different?”