Although a phase II/III mesothelioma clinical trial delivered disappointing results, researchers reviewing its results remain interested in the use of novel dendritic cell immunotherapy. Some reviewers have suggested that the delayed administration of the innovative treatment played a role in it not meeting its primary outcome of improved overall survival.
Mesothelioma Researchers Still Optimistic About Dendritic Cell Therapy
The DENIM mesothelioma study that is drawing these responses tested maintenance treatment with dendritic cell immunotherapy called MesoPher after chemotherapy. Over 15 months of follow-up, it did not improve survival outcomes for patients enrolled in the study compared to supportive care alone, nor did it extend progression-free survival, though it did improve progression-free survival in a subgroup of patients with non-epithelioid disease. The scientists warned that this latter finding should be interpreted cautiously because of the small number of participants.
Despite the fact that the primary outcome of improved overall survival was not met in the trial, both mesothelioma expert Marjorie Zauderer, MD of Memorial Sloan Kettering Cancer Center and Ibiayi Dagogo-Jack, MD, of Harvard Medical School theorized that the goal may not have been met because so much time elapsed between the patients’ last chemotherapy session and the start of the immunotherapy treatment.
Delay in Mesothelioma Treatment Offered as Reason for Disappointing Trial Results
In a review published with the mesothelioma study’s results, Zauderer and Dagogo-Jack wrote, “In DENIM, the interval between the start of the last chemotherapy and day 1 of treatment with MesoPher was nearly three months due to trial logistics and quality control measures. During this vulnerable three-month gap, eight (4.5%) of 176 patients developed progressive disease, including four patients assigned to receive MesoPher.”
They also noted that more than one-third of patients in the treatment group and half of those in the best supportive care group had evidence of disease progression on their first scan after baseline. “These early progression events raise questions about the optimal timing of maintenance therapy, particularly as studies in other difficult-to-treat tumors have observed improved outcomes with earlier initiation of maintenance immunotherapy.” The study’s authors agreed with this assessment.
If you or someone you love has been diagnosed with malignant mesothelioma, novel treatments offer the best hope for longer survival. For information on other clinical trials and innovative approaches, contact the Patient Advocates at Mesothelioma.net today at 1-800-692-8608.
