The past year has brought plenty of good news on the treatment front for mesothelioma patients. Promising study results are showing the way forward to better treatment of this rare cancer. In particular, research continues to point to immunotherapy as a key treatment tool.
Improvements From Mesothelioma Immunotherapy Treatment
- 2020 Food and Drug Administration (FDA) approval: The FDA approved a combination of immunotherapy drugs to treat pleural mesothelioma. The drugs, Opdivo® (nivolumab) and Yervoy® (ipilimumab), showed improved survival compared to chemotherapy.
- 2021 new immunotherapy combination: A study published promising results from treating pleural patients with immunotherapy plus chemotherapy.
In 2022, researchers continued to publish encouraging immunotherapy treatment results.
Mesothelioma Quality of Life Improvements From Checkpoint Inhibitors
In May 2022, researchers shared additional findings from an immune checkpoint inhibitor (ICI) trial. The study built upon earlier results showing ICIs extended survival better than chemotherapy. The 2022 study found improved quality of life for pleural mesothelioma patients treated with the ICIs Opdivo+Yervoy.
Understanding Immune Checkpoint Inhibitors (ICIs)
ICIs are a form of immunotherapy. The immune system has checkpoints to stop immune cells from attacking healthy cells. But cancer cells can exploit checkpoints to hide from the immune system. ICIs stop cancer cells from exploiting checkpoints. Then, the body’s immune cells can attack and kill cancer cells.
Study patients receiving Opdivo+Yervoy reported quality of life improvements that included:
- Improved symptoms: ICI patients tended to report improved mesothelioma symptoms. Chemotherapy patients mostly reported worsening symptoms.
- Improved overall health: ICI patients reported improved health over time. Chemotherapy patients’ health either remained the same or worsened.
- Longer sustained health: ICI patients had longer periods before a drop in health than chemotherapy patients.
Previous research already indicated the benefits of ICIs on survival. The results of this study suggest that these drugs may also provide lifestyle and health benefits.
Checkpoint Inhibitor Treatment Made Patient Eligible for Surgery
A case report from October 2022 described a stage 3 pleural mesothelioma patient’s positive response to ICIs. Doctors treated the patient with Opdivo+Yervoy. Before this treatment, doctors considered the patient’s case inoperable. After treatment with ICIs, they determined that the patient could undergo surgery.
Doctors performed surgery to remove all visible tumor tissue. When they later tested this tissue, they found less than 1% living mesothelioma cells. These findings mean the ICIs may have killed up to 99% of mesothelioma cells before surgery. Five months after surgery, the patient had no signs of cancer.
This case provides early evidence that ICIs may become a way for mesothelioma patients to qualify for surgery. A treatment plan involving surgery is often the most effective way to treat mesothelioma.
Cancer Vaccines Show Early Potential to Treat Mesothelioma
Cancer vaccines are another type of immunotherapy. These vaccines are designed to help train the body to fight cancer. Some have shown early promise in treating mesothelioma.
In June of this year, a small trial published results from using a vaccine plus Opdivo to treat pleural mesothelioma. The treatment was a second-line therapy for patients whose tumors grew after chemotherapy. It reported positive outcomes in pleural mesothelioma patients, including:
- Improved survival: Study patients lived around 11 months. These patients experienced about 35% longer survival than has been reported for other second-line therapies.
- Period without tumor growth: Study patients experienced about 3 months without tumor growth.
There is currently no approved second-line treatment for mesothelioma. Past research into second-line therapy has failed to improve survival. The results of this study indicate that this could change in the future.
Ongoing Cancer Vaccine Clinical Trials
This clinical trial will use a vaccine with Opdivo+Yervoy as a second-line treatment. Patients will have already received chemotherapy. The estimated completion date for the study is March 2027.
Promising Survival Results for Pleural Mesothelioma Patients
A small study reported a 100% 1-year survival rate for pleural mesothelioma patients. In general, 1-year survival for pleural mesothelioma ranges from 50% to 75% with treatment. Study patients underwent the following series of treatments:
- Standard chemotherapy: First, patients received standard chemotherapy.
- Surgery: Chemotherapy was followed by surgery to remove the lining around the lung.
- Heated intrathoracic chemotherapy (HITHOC): After surgery, patients received HITHOC. This procedure uses a heated chemotherapy wash applied directly to the chest cavity.
All three of these treatments are common for mesothelioma. The study’s treatment method could serve as a useful guidepost for future treatment plans. Researchers continue to look into new treatment combinations to help improve patient outcomes.
Hope for Advancements in 2023
This past year has seen research continue to build and improve on past treatment innovations. This work has set the stage for further improvements in the future, including:
- Exploring immunotherapy results in peritoneal mesothelioma patients
- Investigating new types of drugs to treat mesothelioma
- Trying out new drug combinations to treat mesothelioma
Mesothelioma prognosis has been improving in recent years. This improvement is largely the result of new treatments, but new diagnostic methods may have helped. The developments in 2022 give hope that treatment will continue to advance in 2023.