In recent years, researchers and physicians treating people with malignant pleural mesothelioma have expressed great hope for the use of immunotherapy, an innovative treatment that leverages patients’ own immune systems to fight the rare and fatal disease. However, an article published in the April issue of the Journal of Thoracic Oncology points to real-world results from Australian studies to question the protocol’s value.
Article Questions Applicability of Mesothelioma Clinical Trials to Real-Life Use
The article, titled, “Based on the Real-World Results from Australia, Immunotherapy is Not a Good Option for Patients with Mesothelioma,” was written by researchers from Dublin, Ireland, Petah Tikva, Israel, and L’Aquila, Italy. The group contrasted the enthusiasm that has been shown for the use of ipilimumab and nivolumab for unresectable pleural mesothelioma following clinical trials with the real-world outcomes experienced by patients.
Among the most notable points made by the researchers was that there is a minimal overall survival benefit offered by adding immunotherapy drugs to standard chemotherapy, those benefits came at a “serious cost” with an increase in grade 3 to 5 adverse events related to the treatment. Patients needed to be hospitalized following the use of the immunotherapy drugs, and toxicities resulted in increased deaths in the immunotherapy arm of the study as compared to chemotherapy alone.
Increased Cost Burden of Immunotherapy Use in Mesothelioma
According to the researchers, the immunotherapy drugs not only carried significant financial cost for mesothelioma patients, but also the additional cost associated with increased hospitalizations during real-world use. Their analysis indicates that the benefits offered to patients with nonepithelioid mesothelioma patients were notably greater than for those diagnosed with the epithelioid type of the disease, and that consideration should be given to limiting immunotherapy’s use to that group.
In their conclusion, the experts wrote that “the current data for immune checkpoint inhibitors (ICI) for treatment of pleural mesothelioma are not sound enough to currently warrant its use for all comers.” To support this conclusion they point to a twofold increase in drug discontinuation following the use of ICI, as well as three times more serious adverse events or treatment-related deaths, with nearly half of patients requiring hospitalization or additional treatment. Their final assessment is that more observational studies and ongoing trials are needed.
If you or someone you love has been diagnosed with malignant pleural mesothelioma, immunotherapy has offered significant hope for improved outcomes. As more studies are conducted, the Patient Advocates at Mesothelioma.net are here to provide you with the latest information. Contact us today at 1-800-692-8608 to learn more.
