Mesothelioma Articles: Page 1 of 11

For the first time in 16 years, the U.S. Food & Drug Administration has approved a new drug combination specifically for the treatment of malignant pleural mesothelioma. The two drugs, which are to be used together when surgery is not an option, are Opdivo (nivolumab) and Yervoy (ipilimumab).

About 20,000 Americans are diagnosed with malignant pleural mesothelioma each year according to the FDA – the vast majority of which have tumors at diagnosis that cannot be removed by surgery. The devastating cancer is caused by the inhalation of asbestos fibers, often found in manufacturing, construction, mining, military, transportation and other common settings.

When combined, Opdivo and Yervoy improve T-cell function to reduce growth of the patient’s tumor.

“In 2004, FDA approved pemetrexed in combination with cisplatin for this indication, and now patients have an important, additional treatment option after more than a decade with only one FDA-approved drug regimen,” said Dr. Richard Pazdur, director of the FDA’s Oncology Center of Excellence.

The drug therapy was approved after a clinical trial involving over 600 participants with unresectable malignant pleural mesothelioma that had yet to be treated. Patients received doses of both Opdivo and Yervoy every few weeks for up to two years before results were measured.

“Approval of nivolumab plus ipilimumab provides a new treatment that has demonstrated an improvement in overall survival for patients with malignant pleural mesothelioma,” said Dr. Pazdur.

Those who took the new combination survived an average of 18.1 months from diagnosis, compared to 14.1 months for those who received standard chemotherapy.

It can be difficult to navigate the many treatment and legal options presented to mesothelioma patients after they are diagnosed. The experts at the Mesothelioma Help Organization are here to help you make sense of it – reach out today.

Dr. Paul Baas of the Netherlands Cancer Institute and the University of Leiden in Amsterdam recently presented on the CheckMate 743 study at the International Association for the Study of Lung Cancer World Conference. The randomized phase III Checkmate 743 clinical trial prescribed mesothelioma patients who were not candidates for surgery with a combination of first-line nivolumab and ipilimumab.

The promising results yielded a four-month improvement in median overall survival for patients who received the new dual-immunotherapy regimen as compared with those who had received platinum-based chemotherapy, the current double-chemotherapy standard of care for mesothelioma.

“This is the first positive randomized trial of dual immunotherapy in first-line treatment of patients with unresectable MPM,” Dr. Bass noted. “And therefore nivolumab plus ipilimumab should be considered as a new standard of care.”

The patients featured in the phase III trial were randomly assigned treatment plans consisting of either a maximum of two years of nivolumab and ipilimumab, or six cycles of pemetrexed alongside cisplatin or carboplatin.

Results revealed that the treatment plan consisting of nivolumab and ipilimumab yielded comparable efficacy outcomes to chemotherapy for progression-free survival and objective response rate, but was significantly more successful than chemotherapy when it came to the duration of response (DOR). The DOR for the dual-immunotherapy treatment reached 11.0 months whereas the DOR for chemotherapy reached only 6.7 months.

“In the ipi/nivo survival curve, going out to 36 months, we see a plateau at about 30%,… suggesting, as we’ve seen with other trials of immunotherapy, there is a degree of durability that is way beyond what we’ve seen previously with chemotherapy. And this, indeed, may have been driven by maintenance nivolumab,” explained Dr. Dean Fennell of the Cancer Research UK Centre Leicester, University of Leicester and University Hospitals of Leicester NHS Trust.

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Immuno-Oncology News recently published results of a Phase 2 clinical trial of the immuno-checkpoint inhibitor Imfinzi (durvalumab) for patients diagnosed with malignant pleural mesothelioma. 

The PrECOG cancer research group tested the effects of pairing Imfinzi, an AstraZeneca drug that blocks the activity of the PD-1 receptor in immune T-cells, with standard chemotherapy on a group of 55 individuals who had been recently diagnosed with inoperable malignant pleural mesothelioma. The PD-1/PD-L1 pathway affects inflammation, which causes pleural mesothelioma to develop at a faster rate.

The trial revealed that patients who took Imfinzi in addition to running out courses of standard chemotherapy (pemetrexed with cisplatin or carboplatin) survived for an average of 20.4 months, whereas patients who were given only standard chemotherapy lived for an average of 12.1 months. 81.8 percent of participants were male, their median age was 68, and three-quarters of them had been diagnosed with the epithelioid cancer subtype of malignant pleural mesothelioma. 

“[Imfinzi] plus standard chemotherapy delivered a promising median overall survival rate for patients with previously untreated, inoperable malignant pleural mesothelioma,” affirmed Dr. Patrick Forde, director of the Kimmel Center’s thoracic cancer clinical research program, in a news release from the American Society of Clinical Oncology. 

AstraZeneca, PrECOG, and the University of Sydney have plans to enroll participants who have been diagnosed with previously untreated, inoperable malignant pleural mesothelioma in a Phase 3 trial in Australia and the United States in September. More details about the upcoming clinical trial can be found here.

If you or a loved one has been diagnosed with mesothelioma, reach out today for a free consultation. Our experts can assist you with medical resources as well as options for compensation from those responsible.

The EJNMMI Research medical journal recently published an article entitled “FDG PET versus CT radiomics to predict outcome in malignant pleural mesothelioma patients” that outlines a study wherein 72 patients diagnosed with malignant pleural mesothelioma (MPM) at the University Hospital Zurich underwent pre-treatment FDG PET and CT scans alongside curative treatments. In the study, Swiss researchers discovered that using machine-learning radiomics models in conjunction with PET scans to track tumor progress can help doctors better predict outcomes of malignant pleural mesothelioma.

Malignant pleural mesothelioma is a form of cancer caused by exposure to asbestos and makes up 60 to 70 percent of all cases. MPM occurs when tumors develop in the lining of the lungs and chest cavity (called the pleura).

To obtain imaging that will help them diagnose mesothelioma and prescribe treatment for patients, doctors use both CT scans, which combine several x-ray scans from different angles, and PET scans, which use a radioactive tracing fluid to demonstrate tissue and organ functions.

While they did not have the same results with CT scans, the Swiss research team was able to develop a quantitative model using machine learning to more effectively analyze PET scans and predict the movement of tumors.

Because treating mesothelioma often involves varying approaches and exposes patients to many chemicals, it is critical that doctors are able to determine a course of action for each patient that is most responsive to their individual cancer. Malignant pleural mesothelioma is an aggressive cancer that spreads rapidly, so it is imperative that patients begin receiving treatment as quickly as possible.

If you or a loved one has been diagnosed with mesothelioma, reach out today for a free consultation. Our experts can assist you with medical resources as well as options for compensation from those responsible.