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Checkmate 743 Shows Immunotherapy is Better for Mesothelioma Patients Who Cannot Receive Surgery

Published: April 22, 2022

A clinical trial called Checkmate 743, which looks at the immunotherapy drugs nivolumab (Opdivo) and ipilimumab (Yervoy), shows that the combination can create a better quality of life when compared with the chemotherapy drugs pemetrexed, cisplatin, and carboplatin. Patient reported outcomes were recently reported. People who took Opdivo and Yervoy had a better survival rate compared to people who took chemotherapy. The average survival rate for immunotherapy was 18 months while the average survival rate for chemotherapy was 14 months. Doctors need to look at this information and choose immunotherapy drugs more often because they can improve survival in patients.

Immunotherapy is a unique cancer treatment because it utilizes the person’s immune system to fight cancer cells. T cells are one type of cell that can be targeted by immunotherapy drugs. As of April 2022, the only immunotherapy drugs approved for mesothelioma are nivolumab and ipilimumab. They block PD-1 and PD-L1 proteins, which then allows the immune system to see and kill cancer cells. Yervoy does the same thing but for the CTLA4 and B7 proteins. When the two drugs are combined, they work together to better fight mesothelioma and other cancers.

Checkmate 743 wanted to see how immunotherapy works compared to chemotherapy for patients with mesothelioma who could not receive surgery. There were 605 patients divided into two different groups: patients who received immunotherapy and patients who received chemotherapy. It started in 2016 and is still being monitored for quality of life, lung cancer symptoms, symptom burden, and others. The immunotherapy treatment had a significant impact on patients compared to chemotherapy. Patients’ well-being continued to improve overall while the chemotherapy patients’ well-being improved for a short period of time and then declined. Immunotherapy reduced the common symptoms of mesothelioma including chest pain, pleural effusion, and pain when breathing. The only symptom that was not reduced was coughing. The chemotherapy patients’ health on the other hand declined during the trial.

One of the main measurements for Checkmate 743 was quality of life. When compared with each other, immunotherapy created a better quality of life for patients. Tumors also responded better to the immunotherapy treatment since they continued to shrink as treatment went on. The chemotherapy patients on the other hand had short term results. Their cancer shrank but not as fast or as long as the tumors treated by immunotherapy. Based on these results, immunotherapy seems to be a better treatment for patients who cannot receive surgery.

Arnaud Scherpereel et al., “First-line nivolumab plus ipilimumab versus chemotherapy for the treatment of unresectable malignant pleural mesothelioma: patient-reported outcomes in CheckMate 743” Lung Cancer (March 22, 2022). [Link]
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