New Study Looks at Immunotherapy as a Pretreatment to Improve Mesothelioma Survival

Treatment // October 15, 2020
Immunotherapy Pretreatment for Pleural Mesothelioma

Mesothelioma patients typically undergo a multimodal treatment plan. Multimodal therapy incorporates at least two different treatment options. Immunotherapy continues to show promise to improve survival.

One study is looking specifically at immunotherapy as a pretreatment. Immunotherapy done before other cancer treatments could improve survival. The study will use two immunotherapy drugs: Opdivo®️ and Yervoy®️.

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What Is a Pretreatment for Mesothelioma?

Pretreatment occurs before the patient’s primary treatment option. This is also referred to as neoadjuvant therapy.

Pretreatment is not a common component of a mesothelioma treatment plan. However, treatment methods continue to evolve as researchers discover ways to improve survival.

This study uses immunotherapy as a pretreatment. Patients in this study will undergo immunotherapy, followed by surgery. They may then undergo chemotherapy or radiation therapy. All participants will have no previous treatment.

How Does Immunotherapy Work?

Immunotherapy helps the immune system recognize and attack cancer cells. This can help shrink tumors, stop tumor growth and eradicate cancer altogether.

How Will the Study Test Immunotherapy as a Pretreatment?

This study will consist of two treatment regimens. They will use the immunotherapy drugs nivolumab (Opdivo®️) and ipilimumab (Yervoy®️).

First Regimen
  • Nivolumab IV infusion
  • Three treatment cycles
  • Infusions every two weeks for six weeks
  • Performed prior to surgery
Second Regimen
  • Nivolumab IV infusion
  • Ipilimumab IV infusion at the time of the first nivolumab treatment
  • Three treatment cycles (three of nivolumab, one of ipilimumab)
  • Infusions every two weeks for six weeks
  • Performed prior to surgery

Once the patients complete their infusions, they will undergo surgery. After surgery, they may undergo chemotherapy or radiation. Patients should discuss options with their physician. Effective treatment options will vary from patient to patient.

Researchers are hoping to confirm the safety of immunotherapy as a pretreatment. This study will also help determine treatment efficacy and potential to improve patient survival.

How Common Are These Immunotherapy Drugs?

Nivolumab and ipilimumab have been used in previous mesothelioma clinical studies. However, they have never been tested as a pretreatment.

Yervoy and Opdivo were recently approved by the FDA as a first-line treatment for pleural mesothelioma. The treatment combination is the first of its kind to be approved in more than 15 years.

Earlier studies have tested the immunotherapy drugs as a second-line treatment. Patients received the second-line treatment when their cancer didn’t respond to chemotherapy.

Median Survival of Patients in Previous Immunotherapy Studies
Nivolumab
Nivolumab + Ipilimumab

The first study shows improved survival for patients receiving the immunotherapy. Results show combining the drugs was more beneficial than nivolumab alone. The new immunotherapy study may be able to provide additional insight into the treatment combination.

Who Is Eligible for the Clinical Trial?

Requirements of the study are flexible to ensure inclusivity. The study is recruiting 30 participants:

Additional study requirements and details are available in the ClinicalTrials.gov Study Record Detail

Patients should discuss their interest in a clinical trial with their physician. Viable clinical trials and treatment options vary from patient to patient. When selecting patients, clinical trial researchers take a variety of characteristics into account including:

  • Patient age
  • Overall health
  • Other pre-existing conditions

Patients also must consider potential treatment side effects. For this pretreatment study, in particular, side effects may include:

  • Changes in liver function
  • Diarrhea
  • Fatigue
  • Loss of appetite
  • Nausea
  • Pleural effusion*
  • Skin reactions

*Pleural effusion was a less-common side effect demonstrated in previous studies.

A mesothelioma specialist can provide a better understanding of the potential risks and benefits of immunotherapy.