The combination of Yervoy and Opdivo was tested on mesothelioma and the overall survival was promising. The overall survival was 18.1 months versus 14.1 months for patients receiving just chemotherapy. This is the first time that a phase III trial had an improved survival with an immunotherapy combination in a first line setting. Doctors doing the study want to see the combination being used as a first line treatment for mesothelioma because of the good results.
The results show the treatment could be best for the toughest to treat mesothelioma subtypes. Non epithelioid patients (sarcomatoid and biphasic) had a median survival of 18.1 months when treated with Opdivo and Yervoy while those receiving chemotherapy only had an 8.8-month survival rate. The 24-month survival rate for non-epithelioid patients was 38 percent in the immunotherapy group while the survival was eight percent for the chemotherapy group. The treatment has been tested on other cancers and mesothelioma is the sixth cancer to show a better response compared to standard first line treatments.
The two drugs both utilize the patient’s own immune system to treat cancer. Opdivo blocks a signal preventing the patient’s T cells from attacking the cancer while Yervoy targets a specific protein receptor that reduces the immune system’s response to the cancer. They have been tested with mesothelioma before but when tested individually their results were not promising. There is a synergism between the two drugs that make them very effective together.
The treatment consists of patients being given Opdivo every two weeks and Yervoy every six weeks for up to two years unless the disease progresses. The patients receiving chemotherapy in the trial were given chemotherapy every three weeks until toxicity levels became too high or the cancer progressed. Statistics from the study reveal that the one-year survival rate was 68 percent for immunotherapy and 58 percent for chemotherapy. The two-year survival rate was 40.8 percent for immunotherapy and 27 percent for chemotherapy. The progression free survival for immunotherapy at one year was 30 percent and at two years was 16 percent. The progression free survival for chemotherapy was 24 percent at one year and seven percent at two years.
Eighty percent of the immunotherapy patients had side effects, with 30 percent of them being serious. Twenty-three percent of the immunotherapy patients had to stop the treatment because of their adverse side effects.
While the results are promising, the prognosis for mesothelioma is still not good. Mesothelioma is a rare and severe cancer without a cure. More clinical trials could help find the right treatment to lengthen people’s lives and maybe even find a cure. The Opdivo and Yervoy combination is one treatment that is extending lives and at some point could become a new standard when treating patients.