Imjudo (Tremelimumab)

What Is Imjudo (Tremelimumab)?

Imjudo is the brand name of tremelimumab, an immunotherapy drug that shows promise in treating mesothelioma. Imjudo is a specific type of immunotherapy called a CTLA-4 checkpoint inhibitor. It’s called this because it targets the CTLA-4 protein on T cells, a kind of white blood cell that helps the immune system find and fight mesothelioma cells. 

Normally, checkpoints are proteins that prevent immune cells from attacking healthy tissue. Cancers such as mesothelioma use these checkpoints to hide from the immune system. Imjudo blocks CTLA-4, helping T cells detect and attack mesothelioma cells more effectively.

Imjudo is often studied with Imfinzi in mesothelioma research, although it’s not FDA-approved as a standalone treatment for this cancer. Researchers continue to study Imjudo to better understand how it may help people with mesothelioma.

Tremelimumab Information

People with mesothelioma cancer typically receive tremelimumab via IV at a hospital or infusion center. This allows the drug to enter the bloodstream directly over about an hour. After each infusion, people are observed for a short period to monitor for any immediate reactions and ensure safety.

Treatment schedules vary depending on whether Imjudo is given alone or with Imfinzi. Dosages can differ, with typical doses including 1 mg/kg, 10 mg/kg, 15 mg/kg or a flat 75 mg, based on your treatment plan. 

Your doctor will tailor your treatment depending on your overall health, prior therapies and how your body responds. Many people are able to continue their daily activities while receiving tremelimumab. 

Tremelimumab Information
Name	Tremelimumab
Manufacturer	AstraZeneca
Administration Route	IV
Active Ingredient	Tremelimumab
Drug Class	Immune checkpoint blocker, monoclonal antibody
Interacting Drug	Ask your doctor
Alternate Names	Ticilimumab, anti-CTLA 4 monoclonal antibody-Pfizer, CP-675, CP-675206
Dosage	1 mg/kg, 10 mg/kg, 15 mg/kg or 75 mg
Medical Studies	MEDI4736 or MEDI4736 + Tremelimumab in Surgically Resectable Malignant Pleural Mesothelioma
FDA Warning	Skin reaction, skin rash, itching sensation, diarrhea, nausea, fatigue and immune-mediated disorders

How Does Tremelimumab Treat Mesothelioma?

Tremelimumab keeps T cells active to treat mesothelioma. This type of immunotherapy boosts your body’s natural defenses against mesothelioma.

Researchers are testing Imjudo together with Imfinzi because each drug blocks a different protein. Targeting more than one protein gives T cells a better chance to recognize and attack mesothelioma cells. While Imjudo targets CTLA-4, Imfinzi targets PD-L1.

Studies like CheckMate 743 and PrE0505 have shown that dual checkpoint inhibitors help the immune system target mesothelioma from different angles. This can help some people with inoperable pleural mesothelioma live longer and better. Researchers continue to study tremelimumab to see how it may fit into treatment plans for mesothelioma.

Tremelimumab Side Effects

Imjudo can cause side effects in people with mesothelioma that range from mild to severe. The most common side effects seen in studies include digestive issues, fatigue, rash and changes in appetite. Some people may also experience fever or numbness and tingling during treatment.

Common Imjudo Side Effects

• Decreased appetite
• Diarrhea
• Fatigue
• Fever
• Itching (pruritus)
• Nausea
• Numbness or tingling (peripheral neuropathy)
• Skin rash
• Stomach pain

Most Imjudo side effects are mild, but it can sometimes cause rare but serious immune-related reactions. These may include inflammation of the lungs (pneumonitis), liver (hepatitis), intestines (colitis), hormone glands or kidneys. Severe skin reactions and infusion-related reactions can also occur. Corticosteroids can help manage immune-related side effects, gradually reducing them as symptoms improve. 

Report any side effects to your doctor right away, even if they seem minor. Your doctor will monitor blood tests to check liver, thyroid and kidney function during treatment. If side effects occur, treatment may be paused or stopped depending on their severity. 

Is Tremelimumab FDA Approved for Mesothelioma?

Imjudo isn’t FDA-approved for treating mesothelioma. In 2015, the FDA designated it an orphan drug for this rare, aggressive cancer. This designation encourages the development of drugs for rare diseases affecting fewer than 200,000 people in the U.S. 

Orphan drug designation offers incentives to manufacturers to continue research. Treatments for rare cancers like mesothelioma often require years of study before gaining FDA approval.

While tremelimumab isn’t approved for mesothelioma, the FDA approved it in combination with Imfinzi and chemo for certain people with lung cancer and inoperable liver cancer in November 2022. 

Who Is Eligible for Imjudo and Imfinzi?

For people with pleural mesothelioma, Imjudo may be available through clinical trials. Eligibility for each trial varies. Studies often consider factors like cancer stage, prior treatments and overall health. 

Speaking with a mesothelioma specialist can help you learn whether you may qualify for a trial and what to expect if you choose to participate. You can also talk to a Patient Advocate to learn more about joining clinical trials. 

Some people may wonder about receiving Imjudo “off-label” for mesothelioma. But this decision requires careful discussion with a doctor to weigh potential risks and benefits.

Imjudo and Imfinzi are FDA-approved for adults with certain types of metastatic lung cancer. People diagnosed specifically with NSCLC without gene mutations such as EGFR or ALK are eligible. They must also have no medical reasons that would prevent treatment, such as severe autoimmune conditions or uncontrolled infections. Doctors will review each person’s overall health, medical history and treatment goals before recommending this combination.

Tremelimumab for Mesothelioma Clinical Trials

Imjudo is being studied in clinical trials for mesothelioma. Clinical trials are essential to determine whether tremelimumab, alone or in combination with other drugs can improve mesothelioma outcomes. 

Active Tremelimumab Clinical Trials

• NCT05932199 (Recruiting): Testing neoadjuvant durvalumab and tremelimumab with or without chemo for mesothelioma (Durham, NC; Houston, TX).
  
• NCT01843374 (Active, not recruiting): Comparing tremelimumab to placebo in unresectable malignant mesothelioma (multiple U.S. sites).

These studies explore different treatment combinations and stages of care. Discuss eligibility with your mesothelioma specialist or a Patient Advocate. They can also let you know about other trials you may be able to join.

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