Immunotherapy Combination Extends Mesothelioma SurvivalResearch & Clinical Trials
Asbestos.com is the nation’s most trusted mesothelioma resource
The Mesothelioma Center at Asbestos.com has provided patients and their loved ones the most updated and reliable information on mesothelioma and asbestos exposure since 2006.
Our team of Patient Advocates includes a medical doctor, a registered nurse, health services administrators, veterans, VA-accredited Claims Agents, an oncology patient navigator and hospice care expert. Their combined expertise means we help any mesothelioma patient or loved one through every step of their cancer journey.
More than 30 contributors, including mesothelioma doctors, survivors, health care professionals and other experts, have peer-reviewed our website and written unique research-driven articles to ensure you get the highest-quality medical and health information.
About The Mesothelioma Center at Asbestos.com
- Assisting mesothelioma patients and their loved ones since 2006.
- Helps more than 50% of mesothelioma patients diagnosed annually in the U.S.
- A+ rating from the Better Business Bureau.
- 5-star reviewed mesothelioma and support organization.
My family has only the highest compliment for the assistance and support that we received from The Mesothelioma Center. This is a staff of compassionate and knowledgeable individuals who respect what your family is experiencing and who go the extra mile to make an unfortunate diagnosis less stressful. Information and assistance were provided by The Mesothelioma Center at no cost to our family.LashawnMesothelioma patient’s daughter
How to Cite Asbestos.com’s Article
Povtak, T. (2021, July 29). Immunotherapy Combination Extends Mesothelioma Survival. Asbestos.com. Retrieved February 23, 2024, from https://www.asbestos.com/news/2020/08/11/mesothelioma-opdivo-yervoy-trial/
Povtak, Tim. "Immunotherapy Combination Extends Mesothelioma Survival." Asbestos.com, 29 Jul 2021, https://www.asbestos.com/news/2020/08/11/mesothelioma-opdivo-yervoy-trial/.
Povtak, Tim. "Immunotherapy Combination Extends Mesothelioma Survival." Asbestos.com. Last modified July 29, 2021. https://www.asbestos.com/news/2020/08/11/mesothelioma-opdivo-yervoy-trial/.
Standard-of-care treatment for unresectable pleural mesothelioma cancer could be changing soon, sparked by a recently completed international study of a novel immunotherapy combination.
Patients in the randomized mesothelioma clinical trial who were treated with ipilimumab (Yervoy) and nivolumab (Opdivo) had a median overall survival of 18.1 months, compared to 14.1 months for those receiving chemotherapy.
The results of the mesothelioma trial, which was sponsored by Bristol Myers Squibb, were presented at the recent World Conference on Lung Cancer virtual meeting.
Authors of the study said it was the first time an immunotherapy combination used in a first-line setting for pleural mesothelioma improved survival in a large phase III clinical trial.
“Nivolumab and ipilimumab should be considered as a new standard of care,” said study presenter Dr. Paul Baas of the Netherlands Cancer Institute in Amsterdam. “This is a clear signal that this treatment could be of great use for these patients.”
Survival Benefit Greatest in Hard-to-Treat Mesothelioma Subtypes
While the survival improvement was modest overall, there was a dramatic improvement in the traditionally toughest-to-treat mesothelioma subtypes.
For patients with non-epithelioid histology (sarcomatoid or biphasic), median survival was 18.1 months for those receiving the immunotherapy treatment, and only 8.8 months for those receiving standard chemotherapy.
At 24 months, the overall survival rate for non-epithelioid histology was 38% for the immunotherapy group, but only 8% for the chemotherapy group.
“The difference was huge,” Baas said. “We are on the right track.”
According to the study authors, mesothelioma is the sixth different tumor type in which the immunotherapy combination has shown significant benefits over previous standard-of-care mesothelioma treatment.
Opdivo, Yervoy Harness the Immune System
The randomized study involved 605 patients at 114 different treatment centers, including 14 across the United States. Of those patients, 303 received the immunotherapy combination.
The drugs have been used individually with various cancers, but with mixed results in earlier clinical trials for mesothelioma cancer.
Opdivo works by blocking a signal that prevents a patient’s T cells from attacking the cancer. Yervoy targets a protein receptor that downregulates the immune system.
Researchers believe there is a synergy between the two that could be a great benefit for several cancers.
Clinical Trial Shows Survival Advantages Vary
Patients receiving the immunotherapy were given Opdivo every two weeks and Yervoy every six weeks, for up to two years, depending upon disease progression.
Those patients receiving chemotherapy, which included pemetrexed (Alimta) and either cisplatin or carboplatin, were treated every three weeks until unacceptable toxicities or disease progression occurred.
Other notable findings from the study include:
- One-year survival rate: 68% for immunotherapy, 58% for chemotherapy
- Two-year survival rate: 40.8% for immunotherapy, 27% for chemotherapy.
- Progression-free survival at one and two years was 30% and 16%, respectively, for immunotherapy, but only 24% and 7%, respectively, with chemotherapy.
Any treatment-related adverse side effects were found in 80% of the patients receiving immunotherapy and 82% receiving chemotherapy. Serious treatment side effects were found in 30% and 32%, respectively.
Side effects that led to treatment discontinuation occurred in 23% of the patients receiving immunotherapy, but only 16% of those getting chemotherapy.
“Malignant pleural mesothelioma is a devastating disease that has seen limited treatment advances over the past decade,” Dr. Sabine Maier, development lead of thoracic cancers at Bristol Myers Squibb, said in a statement earlier this year. “These topline results from the trial demonstrate the potential of Opdivo plus Yervoy in previously treated patients.”
The success of the combination was not a surprise, based upon earlier phase II studies that studied it in a second-line setting. Lancet Oncology published a study from France in 2019 that showed a median overall survival of 15.9 months and an average progression-free survival of 5.6 months.
Despite the optimism surrounding the combination, a diagnosis of unresectable pleural mesothelioma still comes with a poor prognosis. The five-year, overall survival for the disease is less than 10%.
“Selective targeting of non-epithelioid mesothelioma could further extend the benefit of ipilimumab and nivolumab for patients,” said Dr. Dean Fennell, University of Leicester in England, who was part of the study. “A new standard of care.”