Immunotherapy has become a standard part of mesothelioma treatment in recent years. Doctors already know a lot about immune checkpoint inhibitors (ICIs) as a solo treatment. ICIs are already a standard treatment for inoperable pleural mesothelioma. Researchers are now working to understand how ICIs can work with other treatments, such as surgery.
Recently, a team of researchers in Japan published results that help answer this question. The team looked at using ICIs to address mesothelioma recurrence. Post-recurrence treatment can substantially improve mesothelioma prognosis. So, this new option may be a boon for patients who have already received other mesothelioma treatments.
Study Patients Received Checkpoint Inhibitors After Mesothelioma Came Back
The researchers hoped to understand how well ICIs would fight recurrent mesothelioma. They also wanted to know what kind of side effects the treatment would cause.
The study included pleural mesothelioma patients previously treated with surgery. When the mesothelioma came back, doctors treated it with the ICI combo Opdivo® (nivolumab) and Yervoy® (ipilimumab). Patients stayed on the Opdivo+Yervoy regimen for about 5 months.
For most patients, the Opdivo+Yervoy combo held tumors at bay for months. Other key study results include:
1-Year Survival Rate: 74%
74% of study patients lived one year or longer.
1-Year Progression-Free Survival Rate: 40%
40% of study patients lived one year or longer without signs of tumor growth.
Opdivo+Yervoy Caused Side Effects in the Study
When evaluating new treatments, researchers pay close attention to side effects. A good therapy generally offers substantial benefits without frequent, extreme side effects.
For example, in an earlier Opdivo+Yervoy clinical trial, 30% of patients had serious side effects. But these patients lived longer and had a better quality of life compared to those treated with chemotherapy. These results led to the drug combo’s approval for treating inoperable pleural mesothelioma.
Researchers saw a slightly higher rate of side effects in the new Japanese study. Overall, 34% of study patients had serious side effects from the drugs. The most common serious side effects included:
- Gastrointestinal inflammation: Some patients experienced serious inflammation of the large intestine. This side effect can cause diarrhea or constipation.
- Hepatobiliary disorders: Some patients had problems with the liver, pancreas and gallbladder. These side effects can cause a variety of symptoms, including abdominal pain.
- Pituitary gland dysfunction: Some patients experienced pituitary gland issues that caused low levels of important hormones.
- Thyroid dysfunction: Some patients experienced thyroid problems, like abnormally high or low levels of thyroid hormones.
The study authors do not yet know the cause of this increase in serious side effects. But they suggested it may come from post-surgery patient conditions like inflammation.
Regardless of its cause, researchers did not find the increase in serious side effects overly alarming. The study noted most side effects were manageable. The research team concluded Opdivo+Yervoy is an important treatment option for recurrent mesothelioma.
What Does This Mean for Mesothelioma Patients?
This study does not say which treatment is best after mesothelioma comes back. But it does open a new, advantageous option for recurrence. The Opdivo+Yervoy combo comes with several benefits other treatments do not, including:
- Decreasing symptoms: In a study, Opdivo+Yervoy patients tended to report general improvement in their mesothelioma symptoms.
- Improving general health: Opdivo+Yervoy study patients tended to report increasing health over the course of treatment.
Doctors will not be able to settle on the best treatment for mesothelioma recurrence without more research. In the meantime, Opdivo+Yervoy represent a potentially beneficial option for some patients.
Mesothelioma patients interested in this treatment should discuss it with a doctor. A mesothelioma specialist can help choose the right approach for each patient’s unique characteristics.