From the blog

Pembrolizumab and Chemotherapy Improve Survival in Patients

Published: December 15, 2023

Pleural mesothelioma, a cancer mainly caused by asbestos, is a hard cancer to treat. Diagnosis usually occurs when it is in a late stage, leading to limited treatment options. New clinical trials are always being performed to try to find a new treatment approach that could possibly extend the lives of patients or even cure the disease. A new treatment is now being tested on patients with good results. The treatment involves pembrolizumab and standard chemotherapy and is showing promising results for pleural mesothelioma patients.

The treatment is part of a phase 3 clinical trial that is being conducted in 51 hospitals in Canada, Italy, and France. Participants in the study were 18 years or older, had previously untreated advanced pleural mesothelioma and good overall health besides the mesothelioma. There were two groups in the study. The first group received chemotherapy alone while the second received chemotherapy alongside pembrolizumab. There were 440 patients in the study that ran from January 2017 through September 2020. It was found that the patients who received the chemotherapy and pembrolizumab combination had longer overall survival outcomes compared to those who just received chemotherapy. The average overall survival of patients in the pembrolizumab group was 17 months while the group receiving just chemotherapy had an average overall survival of 16 months.

There were also good three-year survival rates for patients. The patients receiving pembrolizumab alongside chemotherapy had a three-year survival rate of 25 percent. This is better than the chemotherapy only group which was 17 percent. These results could one day mean that pembrolizumab and chemotherapy together could be used to treat mesothelioma and could improve survival outcomes.

There were side effects in certain patients due to the treatment. There were adverse events in 27 percent of patients who received pembrolizumab and chemotherapy. This is higher than the 25 percent of patients that had adverse events in the chemotherapy group. There were also hospital admissions in 18 percent of patients who were treated with pembrolizumab versus six percent of patients in the chemotherapy group. Grade 5 adverse events were rare, happening in two of the pembrolizumab patients and one of the chemotherapy only patients.  This does not mean that pembrolizumab and chemotherapy is not a good treatment option for mesothelioma patients. Clearly there are benefits to the treatment and further studies are warranted to see what benefits pembrolizumab and chemotherapy can bring to mesothelioma treatment.

Quincy Chu et al., “Pembrolizumab plus chemotherapy versus chemotherapy in untreated advanced pleural mesothelioma in Canada, Italy, and France: a phase 3, open-label, randomised controlled trial” The lancet (November 3, 2023). [Link]
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