A study in the United Kingdom involving 332 patients who cannot receive surgery (unresectable) found that patients whose mesothelioma has relapsed can be treated with nivolumab safely. Nivolumab is an immunotherapy drug known as Opdivo, which is popular for treating non-small cell lung cancer. Opdivo is promising because it is the first drug tested to help survival in patients whose mesothelioma has relapsed. Since not many treatments for unresectable mesothelioma exist, more treatments need to be tested and found. If more of them are found, more people’s lives could be extended.
Opdivo is already a part of a first line treatment for mesothelioma. It was recently approved to be used alongside Yervoy in October 2020. Since nivolumab was approved as a first line treatment, it should soon be approved as a second line treatment for the disease as well. Patients who have been using the drug through clinical trials, compassionate care, and off label exceptions have seen mixed results. The most recent study with nivolumab being used as a second or third line treatment saw a 40 percent improvement in survival from 6.6 months in the control group to 9.2 months in the study group. The British study is also showing a 9.4 month median survival and a 12 month overall survival of 40 percent in epithelioid patients, an easier to treat type.
The patients were randomized in a 2:1 ratio. The patients received treatments every two weeks for a maximum of 12 months. Many of the patients had received at least two different types of treatment and relapsed before being enrolled in the current clinical trial.
Other drugs for mesothelioma could be beneficial in treating relapsed mesothelioma. They have had promising results, but results have not been proven in a phase III trial. One drug that has been approved for other cancers is being tested for mesothelioma in a phase II trial. Cancer vaccines are also being tested.
Like other treatments, this clinical trial did have negative side effects in some patients. Forty-five percent of the patients being treated with nivolumab had negative side effects with 36 percent of them being serious while 42 percent of the placebo group had negative side effects with 39 percent of them being serious.
Source:
- Bankhead, “First-Ever Survival Bump in Relapsed Mesothelioma” Medpage Today (January 30, 2021). [Link]
