DREAM Study Results Offer Hope for Mesothelioma Patients

DREAM study

Researchers of a phase 2 clinical trial for pleural mesothelioma testing immunotherapy drug durvalumab with the standard first-line chemotherapy treatment, pemetrexed and cisplatin, have seen encouraging results that suggest the new combination could be a treatment option for patients.

In October, the Journal of Thoracic Oncology published the results of the DREAM study, which was testing the efficacy, safety, and tolerability of durvalumab combined with the standard chemotherapy treatment for patients diagnosed with pleural mesothelioma. Pemetrexed combined with cisplatin is currently the preferred first-line treatment recommended by oncologists to treat mesothelioma, but immunotherapy has shown some success in recent studies and may offer patients another treatment option in the coming years.

According to the study, of the 54 people enrolled in the clinical trial, 31 of them (57%) were progression-free for at least six months. In addition, the median progression-free survival for patients was 6.9 months, while the median duration of response was 6.5 months. These results are encouraging because the authors chose to use the six-month progression-free survival rate as the study’s primary endpoint. On average, a person diagnosed with pleural mesothelioma has a life expectancy of 6 – 12 months, though the patient’s age and overall health can affect those estimates.

This clinical trial joins a growing number of studies taking place to determine what role immunotherapy drugs play in the treatment of malignant mesothelioma. For decades, a combination of cisplatin and pemetrexed has been the preferred treatment method for patients diagnosed with the disease, but immunotherapy may be capable of working in tandem with these drugs to more effectively fight mesothelioma.

Immunotherapy has taken on an increasingly active role in healthcare in recent years because it allows the body to attack cancer cells on its own. The treatment also presents patients with fewer side effects compared to chemotherapy. Typical chemotherapies are systemic, which means they cannot differentiate a cancer cell from a normal one, and end up attacking all cells. Immunotherapy, however, only targets a patient’s immune system and allows healthy cells to continue functioning normally.

In 2017, researchers published a phase 2 clinical trial comparing the efficacy of two immunotherapy drugs, Yervoy® and Opdivo®, as a second-line treatment in patients with pleural mesothelioma. According to the results, patients given a combination of the two drugs had a 12-week disease control rate of 51.9%, compared to only 42.6% for those treated with only Opdivo. Another ongoing phase 2 clinical trial in Japan is testing the effectiveness of Opdivo combined with the standard cisplatin and pemetrexed treatment as a first-line treatment for pleural mesothelioma.

Work still needs to be done to fully prove the efficacy and safety of immunotherapy as a first-line treatment for mesothelioma patients, but there is hope. The treatment has shown success in treating a number of other cancers, and early phase clinical studies have shown promise. With more research and new advancements, it’s possible that immunotherapy could serve as a viable option for mesothelioma patients as a first-, second- or third-line therapy.