Immunotherapy for mesothelioma is a growing field — the first drug combination for this cancer was approved by the U.S. Food and Drug Administration (FDA) as a first-line treatment only a few years ago. But it holds so much promise for patients, especially those facing a late-stage diagnosis or who aren’t eligible for surgery.
Our Oncology Nurse Navigator, Liz Logan, RN, shared some of the most common questions she gets from patients and families about this emerging therapy. Having spent decades in oncology, Liz is excited about the potential of immunotherapy and is passionate about helping families make the most informed decisions about their care.
Below, she walks through how this treatment works, the different types of immunotherapy for mesothelioma, what to expect during your appointments, and how to navigate side effects and costs.
How does immunotherapy for mesothelioma work?
Immunotherapy is a treatment that’s designed to help your own immune system identify and attack cancer cells. Mesothelioma cells can sneak past the body’s natural defenses, but immunotherapy helps train immune cells to recognize the cancer for what it is.
The first FDA-approved immunotherapy combination for mesothelioma was a pair of immune checkpoint inhibitors called nivolumab (Opdivo®) and ipilimumab (Yervoy®). These drugs work by blocking specific checkpoint proteins on your T cells, which are a type of white blood cell that act as a first line of defense against foreign invaders like cancer.
Some patients may receive pembrolizumab (Keytruda®) as part of their treatment plan instead. Keytruda was approved by the FDA in 2024 and is another type of immune checkpoint inhibitor.
Have a specific question about immunotherapy? Nurse Liz is standing by to answer it. Fill out the form below to get on-demand guidance and support.
What’s the process for immunotherapy treatments?
Immunotherapy is a systemic therapy, meaning it works throughout the entire body. It’s typically administered through an intravenous (IV) infusion at a clinic or hospital, and can be given daily, weekly, or monthly at regular intervals called cycles. Your specific cycle will depend on the drug combination, your tolerance to side effects, and whether you’re also getting chemotherapy or another treatment.
For reference, the combination of Opdivo and Yervoy is commonly given every 3 to 6 weeks. Each session usually lasts between 60 and 90 minutes, plus preparation time — though the first appointment may take a little longer. Many patients choose to bring something for entertainment during their sessions, such as a book, a tablet with downloaded movies, or headphones to listen to music or podcasts.
You may be tired after your sessions, and you’ll want to monitor your body’s response and any side effects that come up. This way, your treatment team can help manage any inflammation or discomfort that may arise.
What are the best cancer centers for mesothelioma immunotherapy?
There’s no single best cancer center for immunotherapy, as several factors will impact your treatment and quality of life. However, two of the most important things to look for are a dedicated mesothelioma program and specialized experience in immunotherapy protocols.
Some of the centers that fit that bill include:
- Brigham and Women’s Hospital in Massachusetts
- Mayo Clinic in Minnesota
- UCLA Jonsson Comprehensive Cancer Center in California
- University of Chicago Medicine Comprehensive Cancer Center in Illinois
Comprehensive cancer centers like these also provide the best access to clinical trials for the next generation of immunotherapies, such as personalized vaccines and CAR-T cell therapy. Our team can help you find centers with expertise in your particular case.
What’s the success rate of immunotherapy for mesothelioma?
Immunotherapy has changed the outlook for a lot of mesothelioma patients, especially over the last few years. One of the biggest reasons is the CheckMate 743 clinical trial, which showed that patients who received Opdivo + Yervoy lived longer overall than those who received chemotherapy alone.
One of the biggest takeaways was how well patients with sarcomatoid mesothelioma responded. This aggressive cell type doesn’t typically respond well to chemotherapy, but immunotherapy significantly improved survival.
Patients with epithelioid mesothelioma also benefited. Around 40% responded to immunotherapy, meaning their tumors shrank or stopped growing, and about 1 in 4 patients were still alive 3 years later.
Every person’s situation is different, so I never like to focus on one statistic. What matters is that immunotherapy has given many patients an option that simply wasn’t available a few years ago. Ellen Patton, for example, has lived with pleural mesothelioma for over 25 years thanks to an immune-based therapy.
Which is harder on the body, chemo or immunotherapy?
Neither is necessarily harder on the body than the other, but the two treatments affect people differently. Your individual biology also plays an important role in how your body responds to treatment.
Chemotherapy is cytotoxic, meaning it kills fast-growing cells throughout your body, often leading to hair loss, suppressed immunity, and severe digestive issues. Immunotherapy, however, works by stimulating your immune system; while this can help you avoid many common chemotherapy side effects, it can cause autoimmune-like reactions where the immune system becomes overactive and attacks healthy tissue.
Your medical team can help you weigh these trade-offs based on your overall health, tumor cell type, and personal goals.
What are the side effects of immunotherapy on mesothelioma patients?
Because immunotherapy triggers an immune response, side effects often appear as inflammation.
Some of the most common immunotherapy for mesothelioma side effects include:
- Aches, like body or joint pain
- Digestive issues, including nausea, constipation, appetite changes, or diarrhea
- Fatigue, tiredness, and lack of energy
- Mouth sores
- Skin reactions like rashes, itching, or irritation
The good news is that medical care teams have proactive management strategies for these. If you experience side effects, your doctor may adjust your dosage, prescribe medications to calm inflammation, or use palliative care to manage discomfort.
Be sure to report any new symptoms to your care team immediately, as early intervention is the best way to keep you on your treatment schedule and feeling your best.
How much does immunotherapy for mesothelioma cost? Can I use insurance?
One estimate put the cost of mesothelioma immunotherapy with Opdivo and Yervoy at upward of $292,000 a year.
Although immunotherapy is generally covered by most major health insurance plans and Medicare, out-of-pocket costs can still be substantial. That may include copays, coinsurance, out-of-network services, travel and lodging during treatment, and other unexpected expenses.
These costs are why many patients choose to pursue legal assistance. Financial compensation recovered from asbestos trust funds or personal injury lawsuits can be essential in covering the gap between insurance coverage and the actual cost of specialized care, ensuring you have access to the best treatments regardless of the price tag.
Am I eligible? How do I start?
In order to determine your eligibility, your doctor will perform a thorough review of your pathology report to understand your cell type (epithelioid, sarcomatoid, or biphasic) and overall health.
If your doctor hasn’t mentioned immunotherapy, ask them about it directly. And if you’ve already seen a general oncologist but weren’t given the option to pursue immunotherapy, consider getting a second opinion from a mesothelioma specialist.
Our team of Patient Advocates can help you review your diagnostic information and connect you with experts to determine if you are a candidate for standard immunotherapy or an upcoming clinical trial.
Connect With Nurse Liz for Mesothelioma Support
Immunotherapy is a promising treatment, but it can also be confusing. Nurse Liz and the rest of our knowledgeable, caring team can help you understand your options and see if you can get started with this therapy.
Our Patient Advocates can help you:
- Compare the different immunotherapy drugs
- Find a specialist for a second opinion
- Understand what to expect during treatment
- Explore ways to cover the costs of immunotherapy
Get started by giving us a call at (866) 608-8933 or filling out our contact form now.
