Immunotherapy treatments have once again made headlines, revolutionizing modern medicine and the way we have come to understand cancer treatment. The latest study results published in the American Journal of Case Reports, focuses on Opdivo (nivolumab), a type of check point inhibitor designed to stop immune cells from attacking the healthy cells that are needed to fight off infections.
Malignant pleural mesothelioma is an aggressive cancer with a poor prognosis. Combination chemotherapy is the standard treatment, but because of the nature of this disease, many do not respond to it and the cancer continuously spreads. This particular study focused on a 68-year-old male patient who was diagnosed with malignant pleural mesothelioma and received chemotherapy after an initial surgical procedure to remove tumors. After several round of chemotherapy were found to be ineffective, the patient then received nivolumab and the positive results have scientists and researchers hopeful for a major breakthrough in immunotherapy.
In some cancer patients, especially those with Non-Small Cell Lung Cancer, protein PD-1 is overexpressed. This protein prohibits T cells (which are white blood cells that play a key role in having an effective immune system), from attacking cancer cells. When nivolumab is administered, the proteins that are on the cancer cells are blocked, the T cells function correctly, and the immune system is not compromised. After the administration of nivolumab to the patient, the patient achieved a “sustained response,” which means that the cancer was no longer metastatic. Prohibiting disease progression in an illness that is notorious for its rapid development has pointed scientists and researchers in the direction to explore why this was so successful, and if its success can be duplicated for others that are suffering.
Pleural mesothelioma originates in the lining of the lungs, but once tumors are formed, the infected cells are able to travel to other parts of the body which results in tumors spreading (metastatis). Once the infection has spread to other parts of the body, it becomes more advanced, difficult to treat, and ultimately control.
Once the cancer has spread and the patient weaker, aggressive treatment plans like surgery are no longer an option. However, if metastasis can be slowed, or even halted, the patient could regain strength and receive the more hardline treatments that they were unable to handle before. In this most recent study where nivolumab was administered, the cancer stopped progressing further and now has the potential to become more manageable. A longer prognosis is also a possibility.
Nivolumab has been approved by the FDA to treat other cancers which include: renal cell carcinoma, classical Hodgkin lymphoma, and melanoma. In June 2018 China approved nivolumab and it became the country’s first immune-oncology and PD-1 therapy.
Riley G. Jones, et. al, “Nivolumab Immunotherapy in Malignant Mesothelioma: A Case Report Highlighting a New Opportunity for Exceptional Outcomes,” American Journal of Case Reports (2018). [Link]