Though chemotherapy has long been considered the gold standard treatment for malignant pleural mesothelioma, clinical studies are increasingly pointing to a combination of immunotherapy drugs as providing significantly better overall survival.
Large Clinical Study Suggests Substantially Better Mesothelioma Outcomes
According to Dr. Paul Baas of the Netherlands Cancer Institute in Amsterdam, pleural mesothelioma patients treated with a combination of Opdivo and Yervoy had a median overall survival of 18.1 months as compared to 14.1 months for patients who had been randomized to chemotherapy. Notably, the immunotherapy combination performed well in both epithelioid and non-epithelioid tumors, while those patients treated with chemotherapy provided substantially worse results for those with non-epithelioid tumors. Among that group, immunotherapy more than doubled overall survival time.
The mesothelioma patients whose tumors were categorized as PD-L1 saw the best results from the combination treatment. According to Baas, “The survival benefit with nivolumab and ipilimumab was observed regardless of histology, while chemotherapy performed better in epithelioid histology, as expected. The PD-L1 data are descriptive in nature and preclude firm conclusions. This is the first positive randomized trial of dual immunotherapy in the first-line treatment of patients with mesothelioma. Therefore, nivolumab and ipilimumab should be considered as a new standard of care.”
Results Point to Immunotherapy as “New Standard of Care”
Commenting on the mesothelioma study results at the World Conference on Lung Cancer, Dean A. Fennell, MD of the University of Leicester in England said that the combination treatment would likely set “a new standard of care.” He went on to say, “Non-epithelioid histology exhibited marked chemoresistance, potentially associated with epithelioid mesenchymal transition, but was not positively predictive. Looking forward, chemoimmunotherapy or selective targeting of non-epithelioid mesothelioma could further extend the benefit for patients with ipilimumab and nivolumab.”
The news is a rare positive for those who are faced with a diagnosis of malignant pleural mesothelioma. The current prognosis is grim, and particularly for those deemed to have tumors that are unresectable. Where previous studies on the use of just one immunotherapy drug have provided little hope for improvement, the combination approach is far more encouraging.
If you or someone you love has been diagnosed with malignant pleural mesothelioma and you need information on the most innovative treatments available, the Patient Advocates at Mesothelioma.net can help. Contact us today at 1-800-692-8608.
