From the blog

New Clinical Trial Testing Effectiveness of Immunotherapy and Chemotherapy Before Surgery

Published: December 6, 2019

Mesothelioma, the cancer of the linings of different organs, but primarily the lungs, has a poor prognosis and survival rate for those who are diagnosed. Since there is no cure, treatments helping to extend people’s lives need to be tested. Clinical trials help doctors find new ways to treat mesothelioma and other cancers, possibly extending or even saving people’s lives. They are constantly being tested to find the best available treatment for different cancers.

A new clinical trial focusing on pleural mesothelioma is being conducted at the Memorial Sloan Kettering Cancer Center in New York City. The trial is looking at the combination of immunotherapy and chemotherapy to see how effective it is prior to the patient going through aggressive surgery. The drugs being tested are Opdivo, which is an immunotherapy drug, and Alimta, which is a type of chemotherapy with either cisplatin or carboplatin, which are both chemotherapy drugs. Their combination will be studied to see if when used together they will be able to extend patients’ survival time. This has been tried with other cancers and succeeded so doctors are hoping that it can be repeated with mesothelioma.

Treatment consists of two cycles of the Opdivo and chemotherapy combination before the patient undergoes a pleurectomy and decortication procedure. Pleurectomy and decortication is a surgical procedure where the pleura (mesothelium that surrounds the lungs) is removed and tumors are removed from the chest and lung surface. The study is examining how many patients are able to move on to surgery within the 30 days of their original surgical date. If patients are not able to undergo surgery, they will be delayed for more than 30 days, which will be considered a toxicity induced failure.

This specific trial is only open to people who are able to undergo surgery, which is less than a third of patients diagnosed with pleural mesothelioma. Patients who have already been treated with immunotherapy or chemotherapy are also ineligible for this treatment. Opdivo, along with other immunotherapy drugs, has had mixed results when fighting cancer. It ranges from doing a very good job to not working at all. Currently, Opdivo is not approved for use on mesothelioma, but is used on patients in clinical trials and in certain special use exemptions. A recent study looking at the effectiveness of immunotherapy drugs Opdivo and Keytruda found that these drugs only help around 13 percent of patients who use them. New clinical trials could help doctors figure out the best ways to use these drugs and could help unlock their potential.

“A Study of Nivolumab and Chemotherapy Followed by Surgery for Mesothelioma” Clinical Trials (November 13, 2019). [Link]
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