Immunotherapy for Mesothelioma
Mesothelioma immunotherapy uses medications to help the body’s own immune system fight malignant mesothelioma in several ways: by teaching the body to recognize cancer cells as harmful, by preventing the cancer from decreasing the immune response, or by helping the body’s immune system kill the cancer cells.
Immunotherapy differs from chemotherapy. It is a more targeted treatment which only kills abnormal cells, while chemotherapy also kills cells that are healthy. Immunotherapy side effects are also milder than side effects of other aggressive treatments.
The FDA approved the immunotherapy drugs Opdivo® (nivolumab) and Yervoy® (ipilimumab) as a treatment for pleural mesothelioma in October 2020.
Further, in July 2021, clinical trial results testing atezolizumab plus bevacizumab found that peritoneal mesothelioma patients had an objective 40% response rate. About 85% of patients experienced a survival rate of over one year and 61% of patients were progression-free.
- Immunotherapy works by improving how the patient’s own immune system fights cancer.
- Clinicaltrials.gov currently lists dozens of mesothelioma immunotherapy trials that are available to mesothelioma patients.
- Current studies suggest that immunotherapy works best when combined with surgery or chemotherapy.
- In 2018, the Nobel Prize in Physiology or Medicine was awarded to the discoverers of immunotherapy for cancer, marking just how promising this new cancer treatment is.
Types of Mesothelioma Immunotherapy
There are several different types of immunotherapies, each with their own particular focus. The most common immunotherapies are listed below.
Cancer Vaccines
Cancer vaccines work with the immune system to help the body learn to defeat cancer cells. These vaccines are usually made by either editing your own immune cells to better respond to cancer cells, or by helping your immune cells better identify which cells are cancerous.
Researchers are currently working on preventative mesothelioma vaccines. CRS-207 is a listeria-based cancer vaccine that has had some success in clinical trials.
A Norwegian biotech firm, Targovax, has also had early signs of success in its ONCOS-102 trial testing mesothelioma vaccines in combination with standard chemotherapy in several patients.
Immune Checkpoint Inhibitors
Immune checkpoint inhibitors prevent cancer cells from hiding from the body’s immune system. This is done by targeting certain proteins on cancer cells called “checkpoints.” The checkpoints targeted by mesothelioma immunotherapies include CTLA-4, PD-L1 and PD-1.
Some checkpoint inhibitors are:
- Pembrolizumab (Keytruda)
- Nivolumab (Opdivo), often used with Ipilimumab Atezolizumab (Tecentiq) and Avelumab (Bavencio)
- Durvalumab (Imfinzi)
- Cemioimab (Libtayo)
- Avelomab (Bavencio)
Monoclonal Antibodies
Monoclonal antibodies focus on a particular site inside of a cancer cell, such as a protein or enzyme. Sometimes antigens on the surface of a cell are also targeted. Monoclonal antibodies used to treat mesothelioma include Tremelimumab and Amatuximab.
Cytokines
These are proteins, sometimes grown in a lab, that help the body increase the nonspecific immune response to cancer cells. Some cytokines help the immune system cells grow more quickly, while others help the body resist cancer cells.
Other Types of Mesothelioma Immunotherapy
The last major types of immunotherapy being tested are immunomodulators. These drugs work with the immune system by heightening some proteins and calming down others.
These drugs include:
- Thalidomide
- Lenalidomide
- Pomalidomide
Other immune therapies that are being studied include:
- Bacillus Calmette-Guerin: A germ that infects human tissue and activates the immune system. This is usually a liquid treatment for bladder cancer. This is one of the oldest immunology treatments for cancer.
- Imiquimod: A drug for skin cancer, usually a cream that promotes a local immune system response where applied.
Benefits of Immunotherapy for Mesothelioma
Immunotherapy has already helped many cancer patients, and now the many benefits of the innovative treatment are being used for mesothelioma patients.
According to a 2017 study by Dr. Gerard Zalcman, the one-year overall survival rate for mesothelioma patients was 51% when they were taking the immunotherapy drug nivolumab (brand name Opdivo®), and 58% if they combined that drug with ipilimumab.
As doctors continue to make immunotherapy advances for mesothelioma treatment, there’s hope that more patients may be able to access these benefits.
Mesothelioma Prognosis After Immunotherapy
Immunotherapy may improve mesothelioma prognosis, or the general course doctors expect a patient’s mesothelioma to take.
As noted by the FDA, those who received Opdivo® and Yervoy® over a two-year period had a median survival time of 18 months, while patients who were treated with just chemotherapy lived for only 14 months.
Other immunotherapy treatment options are still being tested in clinical trials. As the trials show promising results, they are moving toward becoming first-line treatment options. These treatments work well by themselves and as an addition to chemotherapy or surgery.
To learn more about improving your prognosis, reach out to our team of Patient Advocates.
Mesothelioma Immunotherapy Multimodal Treatment
Doctors often use immunotherapy for mesothelioma in combination with other treatment plans like chemotherapy, virotherapy, and surgery.
Chemotherapy and Immunotherapy
Researchers are aware that it is vital for the body’s immune system to recognize cancer cells as harmful so that it can control, prevent and shape the tumors growing in the patient’s body.
However, some chemotherapy for mesothelioma is ineffective when it comes to teaching the body’s immune system to recognize and attack cancer cells.
While the chemotherapy fights off cancer, active immunotherapy can fill in the gap, teaching the immune system to recognize cancer cells as harmful.
Surgery and Immunotherapy
Immunotherapy for mesothelioma can be used as adjuvant or additional therapy after a patient has had mesothelioma surgery. Immunotherapy after surgery reduces the risk of recurrence by enabling the body to recognize and fight off cancer cells that are trying to spread and grow.
Virotherapy and Immunotherapy
In virotherapy, viruses are altered so that they duplicate themselves better inside tumor cells than in healthy cells. Then, immunotherapy can be used to target drugs to go where the virus is and target cancer cells through their proximity.
Mesothelioma victims may be eligible for financial compensation to help them afford various treatment costs.
Immunotherapy Side Effects
While mesothelioma immunotherapy has fewer side effects than other cancer treatments, it still has some. These side effects may be different for each person, and they will depend on the specific drugs and types of immunotherapy being done.
Some of the possible immunotherapy side effects include:
- Weight gain due to the patient’s body holding in more fluids
- Inflammation near the injection site, which appears as pain or itching and burning sensation near the site
- Flu-like symptoms such as fever, chills, nausea, and congestion
- Changes to the patient’s blood pressure or heart palpitations
- Trouble breathing, tiredness, dizziness or muscle pains
- Reactivation or triggering of an immune response against normal body organs, such as the lining of the heart or lungs, colon, joints, or other organs
Because some of these treatments are new and you may be encountering them while part of a clinical trial, all side effects will be monitored closely.
Consulting with your doctor can help determine what your symptoms may be and which treatment option will be best for you based on the symptoms you may experience.
Get Immunotherapy Treatment for Mesothelioma
Mesothelioma therapies continue to evolve as researchers look for novel ways to boost immune system function in the fight against mesothelioma.
With the FDA’s approval of Opdivo® and Yervoy®, patients may have another option they can access to live longer. Other immunotherapy options continue to be studied.
Patients who are looking to use immunotherapy to help treat their mesothelioma should speak with their doctor. Contact Mesothelioma Hope for help finding a care practitioner.
