According to a new study published in the journal Clinical Lung Cancer, researchers from Heidelberg University and 11 other German cancer centers have found that, in 72% of cases, mesothelioma patients who receive platinum and pemetrexed chemotherapy after their first-line immunotherapy treatment stops working can achieve a median overall survival of 11.5 months and disease control. This is critical evidence that prior immunotherapy does not compromise chemotherapy’s effectiveness for the challenging, asbestos-related cancer.
Mesothelioma Chemotherapy Remains Effective, Even After Immunotherapy Failure
The multicenter retrospective study analyzed the outcomes for 135 mesothelioma patients who received first-line nivolumab and ipilimumab immunotherapy. Of those 135 patients, 57 (42%) went on to receive second-line treatment when their immunotherapy stopped working. Among those 57, the majority (72%) received platinum plus pemetrexed chemotherapy and experienced a median overall survival of 11.5 months and median progression-free survival of 5.8 months from the start of second-line treatment.
That 72% of patients’ tumors either shrank or stopped growing is particularly encouraging, given that no second-line treatment has received formal approval for mesothelioma. Partial responses were seen in 28% of patients, with stable disease in another 47%. Treatment responses were observed regardless of whether the patient had responded to the first-line immunotherapy. This confirms that the platinum and pemetrexed combination retains its activity in the post-immunotherapy setting and that the two treatment approaches do not interfere with each other.
Mesothelioma patients who received second-line platinum and pemetrexed achieved a median overall survival of 17.1 months calculated from original diagnosis. This is meaningfully longer than the 9.5 months seen in patients who received no further treatment after immunotherapy failure, and confirms the importance of planning second-line treatment proactively rather than waiting until physical deterioration limits patients’ options.
Early Planning for Mesothelioma Treatment Can Counter Attrition Challenge
In addition to the promising second-line outcome data, the mesothelioma study also revealed the challenges of patient attrition in the treatment process. Of the 135 patients who started immunotherapy, 58% failed to progress to second-line treatment, and of those who did receive second-line chemotherapy, only 16% of the original cohort went on to receive third-line treatment. This means that the vast majority of mesothelioma patients exhaust their ability to tolerate further treatment long before running out of options.
The high attrition rate demonstrates both mesothelioma’s aggressive nature and the physical toll it takes on patients over time. The researchers stress that their findings highlight the importance of early consideration of second-line treatment in mesothelioma patients who remain fit and that waiting too long risks disease progression or physical deterioration that makes further treatment impossible.
If you or someone you love has been diagnosed with mesothelioma, the results of the German study are both encouraging and sobering. For information on the resources available to you, contact the Patient Advocates at Mesothelioma.net today at 1-800-692-8608.
