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Durvalumab and Chemotherapy Extends Mesothelioma Patients’ Lives

Published: December 10, 2021

Studies are showing that the immunotherapy drug durvalumab can make chemotherapy more effective for treating mesothelioma. Durvalumab is an immunotherapy drug called an immune checkpoint inhibitor. It blocks the protein PD-1, which is used by mesothelioma cells to protect themselves. Researchers believed that if the protein was blocked, mesothelioma cells would be easier to kill with chemotherapy. The results of the study prove that the researchers’ hypothesis was correct. This treatment could potentially help patients with hard to treat and inoperable mesothelioma.

Durvalumab and Keytruda both block the PD-1 protein. These types of immunotherapy are promising, but they are not always the first choice doctors make when treating mesothelioma. Chemotherapy used with Alimta is the primary treatment doctors choose, but surgery alongside chemotherapy is also a good option to extend survival. The problem with chemotherapy is that the majority (around 60 percent) of patients do not respond to it. Many patients also cannot receive surgery because their cancer has spread too much. Durvalumab could be a good option for these patients.

The median overall survival for mesothelioma patients who take chemotherapy is one year. When patients were also treated with durvalumab the median overall survival improved to 20 months. Patients with epithelioid mesothelioma saw an even better survival of 24.3 months. Researchers discovered that the patients with the most genomic abnormalities had the best response to durvalumab. The researchers concluded that when durvalumab was administered with platinum-based chemotherapy, a good response can occur, but it depends on the genomic background of a patient’s pleural mesothelioma.

There were 55 patients with pleural mesothelioma who could not receive surgery in the study. The main side effects were mostly from the chemotherapy, but durvalumab also created mild side effects. The researchers were also able to create tests to help them determine which patients would most benefit from the durvalumab and chemotherapy combination. The researchers did this by looking at the profiles of the individual patients and comparing them with one another. Now the researchers need to perform the study in a larger group of people. A clinical trial will enroll 480 mesothelioma patients between the agers 18 and 70. The patients must not have received any type of treatment and they must be ineligible for surgery.

Patrick M. Forde et al., “Durvalumab with platinum-pemetrexed for unresectable pleural mesothelioma: survival, genomic and immunologic analyses from the phase 2 PrE0505 trial” Nature Medicine (November 8, 2021). [Link]
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