What Is Mesothelioma Immunotherapy?
Immunotherapy for mesothelioma is a treatment that uses the immune system to target and destroy cancer cells.
The most well-known type of immunotherapy is a class of medication called immune checkpoint inhibitors. These drugs help “unblock” your immune system so it can fight mesothelioma cancer more effectively. They’re often used alongside surgery, chemotherapy, and other mesothelioma treatments.
Other types of cancer immunotherapies include:
- Adoptive cell therapy
- Monoclonal antibodies
- Vaccines
Immunotherapy for mesothelioma can be a powerful tool for patients whose cancer has spread to other areas of the body or can’t be surgically removed.
Not everyone is a candidate for immunotherapy, but it can significantly improve quality of life and even extend survival in the right circumstances.
Key Facts on Immunotherapy and Mesothelioma
- Opdivo® and Yervoy® were the first drugs approved by the U.S. Food and Drug Administration (FDA) as immunotherapy for pleural mesothelioma in October 2020.
- In September 2024, Keytruda® was approved as another immunotherapy option for pleural mesothelioma in combination with chemotherapy.
- Researchers continue to study CAR T-cell therapy, vaccines, and other immunotherapies in mesothelioma clinical trials.
Download our Free Immunotherapy Guide to learn more about this treatment and whether it could be right for you.
How Does Immunotherapy for Mesothelioma Work?
Immunotherapy enhances the immune system’s ability to fight mesothelioma cancer more effectively.
It does this in two ways:
- Making the immune system stronger so it can fight mesothelioma cells
- Identifying and attacking receptors (parts of cancer cells that help them hide from the immune system)
In addition to immunotherapy, targeted therapies are being developed to attack specific genes and proteins that help mesothelioma grow, spread, or avoid being detected by the immune system.
Mesothelioma Immunotherapy vs. Chemotherapy
Chemotherapy targets cancer directly, while immunotherapy works by empowering your immune system to fight the disease on its own.
Both treatments can be used together in what’s known as chemoimmunotherapy, but there’s evidence that immunotherapy may be more effective than chemotherapy for certain mesothelioma cell types.
In the CheckMate 743 clinical trial, immunotherapy helped patients with sarcomatoid mesothelioma live 4 months longer than those treated with chemotherapy.
“Immunotherapy is like giving your body an extra set of tools to combat the disease more effectively.”
Who Does Mesothelioma Immunotherapy Work Best For?
Immunotherapy for mesothelioma can be an effective option for many patients. Your doctor can help you decide if it’s a good fit with your current treatment plan.
Immunotherapy may be used:
- After a mesothelioma diagnosis
- If surgery isn’t an option
- In combination with other treatments
- When other treatments have failed
Patients may also be able to access immunotherapy drugs being tested in clinical trials.
“We did three sessions of chemo, and that wasn’t doing anything. We started immunotherapy, and after several weeks some of the cancer started to shrink a little bit.”
Immunotherapy for Mesothelioma: Success Rate
Opdivo and Yervoy improved median overall survival to 18.1 months in patients with inoperable pleural mesothelioma, according to results from the CheckMate 743 trial.
About 23% of patients were still alive after 3 years (a figure known as the survival rate). Even more impressive, 8 of the patients had their cancer go into complete remission.
Immunotherapy for peritoneal mesothelioma has also shown success. A 2024 Cureus report highlighted the case of a patient who went into remission after 2 years of treatment with Keytruda and is still alive over 4 years later.
Use our Free Doctor Match to connect with a local mesothelioma specialist who has knowledge of the latest immunotherapy treatments.
4 Types of Mesothelioma Immunotherapy
There are four main types of immunotherapy for mesothelioma, and each works differently to fight cancer. Learn more about these options below to help you or a loved one make informed decisions about your treatment plan.
1. Immune Checkpoint Inhibitors
Immune checkpoint inhibitors target proteins like PD-1 and CTLA-4 on T cells, a kind of white blood cell. These proteins act like off-switches that slow down the immune system. They keep the body from attacking healthy cells but can also stop the immune system from fighting cancer.
Checkpoint inhibitors turn these off-switches back on so the immune system can find and destroy mesothelioma cells.
Examples of checkpoint inhibitors include:
- Atezolizumab (Tecentriq®)
- Avelumab (Bavencio®)
- Cemiplimab (Libtayo®)
- Durvalumab (Imfinzi®)
- Ipilimumab (Yervoy®)
- Nivolumab (Opdivo®)
- Pembrolizumab (Keytruda®)
Opdivo, Yervoy, and Keytruda are FDA-approved as first-line treatments for advanced pleural mesothelioma that can’t be surgically removed.
Keytruda can be used as a second-line (follow-up) treatment for cases of peritoneal mesothelioma that don’t respond to standard treatments.
“Immunotherapy and the combination of Opdivo and Yervoy was really a game changer. It’s the first sort of hope we’ve had for this more aggressive disease.”
2. Cancer Vaccines
Mesothelioma vaccines work by helping the immune system recognize cancer cells more effectively. They are currently only available in clinical trials.
Vaccines being tested for mesothelioma include:
- CRS-207, a vaccine made with listeria bacteria shown to produce an immune response against mesothelioma
- Galinpepimut-S (GPS), a vaccine that targets the WT1 protein commonly found in mesothelioma cells
- ONCOS-102, a vaccine that shows promise in combination with chemotherapy
- Poly-ICLC, a vaccine that is injected into tumors before surgery
- UV1, a vaccine that targets the enzyme telomerase, which is a known sign of cancer
These vaccines are part of promising research that could give mesothelioma patients better treatment options.
3. Monoclonal Antibodies
Monoclonal antibodies are special proteins made in a lab to help fight cancer. They can stop cancer from growing or help the immune system attack cancer cells.
Some monoclonal antibodies used to treat mesothelioma include:
- Amatuximab: This antibody boosts the immune system’s ability to attack cancer cells. It’s often combined with other immunotherapies, like the checkpoint inhibitor Imfinzi.
- Tremelimumab (Imjudo®): This targets a protein called mesothelin, which is overproduced by mesothelioma cells. By attaching to mesothelin, Imjudo helps the immune system recognize and attack cancer cells.
In one clinical trial, 90% of pleural mesothelioma patients had their cancer stabilize with the immunotherapy amatuximab plus the standard chemotherapy drugs pemetrexed (Alimta®) and cisplatin. “Stabilize” means their tumors didn’t grow or spread during treatment.
4. Adoptive Cell Therapy
Adoptive cell therapy is where doctors collect a patient’s immune cells (usually T cells) and modify them outside the body to make them better at fighting mesothelioma. The most well-known example is CAR T-cell therapy.
CAR T-cell therapy involves:
- Drawing blood from the patient
- Extracting their T cells with a special machine
- Genetically modifying them to carry chimeric antigen receptors (CARs) that specifically target mesothelioma cells
- Giving the modified CAR T cells back to the patient through an IV infusion
Since this therapy uses the patient’s own cells, it minimizes the risk of their immune system rejecting them.
Researchers are now testing whether injecting T cells directly into solid tumors could be more effective than giving them through an IV.
Benefits of Immunotherapy for Mesothelioma
The main benefit of immunotherapy treatment for mesothelioma is that it can improve life expectancy in some patients.
Additional benefits of immunotherapy include:
- Causing fewer and more mild side effects than chemotherapy
- Helping the immune system fight cancer even after treatment has stopped
- Increasing the odds of mesothelioma remission (where all signs of cancer disappear)
- Shrinking tumors and preventing the cancer from spreading
As doctors continue to study the benefits of immunotherapy, more patients may be able to access this treatment and become mesothelioma survivors.
“I have some anecdotal evidence of people who’ve been treated just with immunotherapy who had near complete resolution of their tumors for an extended period of time without any other intervention. It’s been quite remarkable.”
Multimodal Mesothelioma Treatment and Immunotherapy
Mesothelioma immunotherapy is poised to play a key role in many multimodal treatment plans. Multimodal therapy is when two or more treatments are used together to help control the spread of cancer.
Learn more about the use of immunotherapy with chemotherapy and surgery and how it has the potential to become a new standard of mesothelioma care.
Chemotherapy With Immunotherapy for Mesothelioma
Chemotherapy involves injecting patients with specific medications to help kill cancer cells that have spread (metastasized) throughout the body.
New studies suggest that combining chemotherapy and immunotherapy — known as chemoimmunotherapy — may be the best way to increase survival in patients whose cancer is unresectable (unable to be removed through surgery).
For example, the PrE0505 clinical trial found that patients who received chemoimmunotherapy lived over 8 months longer than those who only received chemotherapy.
Surgery With Immunotherapy for Mesothelioma
Patients can get immunotherapy before or after mesothelioma surgery to help the body kill any cancer cells that may try to grow back.
A Baylor College of Medicine clinical trial found that treating pleural mesothelioma patients with Imfinzi and/or Imjudo about 3 weeks before surgery led to longer survival. Additionally, more than 1 in 3 patients had their tumors shrink.
In April 2024, a study in Frontiers in Oncology reported the case of a 58-year-old pleural mesothelioma patient who went into complete remission after 5 cycles of Opdivo and Yervoy and surgery. He was still alive 6 months later with no signs of the cancer returning or spreading.
Get our Free Mesothelioma Survivors Guide to read about patients who are thriving many years after their diagnosis.
Mesothelioma Immunotherapy Side Effects
Some people may experience side effects from mesothelioma immunotherapy, though not everyone does. The specific treatments and your overall health can affect which side effects you experience and how severe they are.
Common side effects of immunotherapy for mesothelioma include:
- Changes in appetite
- Constipation or diarrhea
- Fatigue
- Flu-like symptoms
- Heart palpitations
- Nausea
- Skin irritation, rash, or itching
Your medical team will monitor you closely for side effects during immunotherapy. They may prescribe medications to help with nausea or use steroids to reduce inflammation. If you have a serious reaction to a drug, your doctor may have you stop taking it.
Download our Free Immunotherapy Guide to learn more about possible side effects and how to manage them.
How Much Does Immunotherapy for Mesothelioma Cost?
The cost of mesothelioma immunotherapy with Opdivo and Yervoy can exceed $292,000 a year, according to an article in Frontiers in Oncology.
Reuters has also reported it costs an average of $150,000 every year for checkpoint inhibitors like Keytruda and Imfinzi.
Mesothelioma Hope understands the high costs of immunotherapy and other treatments can be a significant burden for cancer patients. This is why we’re committed to helping you navigate the financial challenges of a mesothelioma diagnosis.
Contact our Patient Advocates to learn about asbestos claims, veterans benefits, and other ways to access compensation for your medical treatment.
The Future of Mesothelioma Immunotherapy
Immunotherapy is one of the most promising advancements in the treatment of mesothelioma. Researchers are studying innovative ways to harness the power of the immune system to fight this aggressive cancer.
Some key areas shaping the future of immunotherapy for mesothelioma include:
- Advancements in T-cell therapy: Clinical trials are underway to improve this new treatment and make it available to more mesothelioma patients. Part of this includes finding ways to help CAR T-cells stay active in the body longer so they can continue fighting tumors.
- Combination therapy: Doctors are identifying the most effective way to combine immunotherapy with other mesothelioma treatments. For instance, the SMARTEST trial is testing Imfinzi and Imjudo as an adjuvant (post-surgery) treatment for pleural mesothelioma patients.
- Precision medicine: Scientists are looking at ways to test specific immunotherapies that can help patients with rare or unique genetic mutations like BAP-1. This more precise approach could change the way mesothelioma is treated.
Looking ahead, the future of mesothelioma immunotherapy is full of possibilities. Advances in cancer research are helping doctors target the disease more precisely.
“I think there will be an immunotherapy component for pretty much everything at some point.”
Get Help Accessing Immunotherapy for Mesothelioma
When it comes to mesothelioma immunotherapy, having the right medical team by your side is crucial. Mesothelioma Hope can help you find a local oncologist who specializes in immunotherapy.
We can also help you:
- Access the latest immunotherapy drugs in clinical trials
- Connect with other patients receiving immunotherapy
- Learn what to expect from mesothelioma immunotherapy
- Pursue compensation for treatment, travel, and out-of-pocket expenses
Call us now at (866) 608-8933 or use our Free Doctor Match to get started.
Mesothelioma and Immunotherapy FAQs
Can mesothelioma be treated with immunotherapy?
Yes, immunotherapy is a treatment option for mesothelioma. Immunotherapy drugs work by helping the body’s immune system recognize and attack cancer cells.
The FDA has approved the combination of nivolumab and ipilimumab, two immune checkpoint inhibitors, for the treatment of inoperable pleural mesothelioma. This combination has demonstrated an ability to extend survival in some mesothelioma patients compared to chemotherapy alone.
What are the approved immunotherapy drugs for mesothelioma?
The approved immunotherapy drugs for mesothelioma include:
- Opdivo (nivolumab): Blocks a protein that helps cancer cells hide from the immune system
- Yervoy (ipilimumab): Works like Opdivo but targets a different protein on immune cells
- Keytruda (pembrolizumab): Works the same as Opdivo but is combined with chemotherapy for the best results
More immunotherapies could potentially be approved for mesothelioma in the future if they show positive results in clinical trials.
How effective is immunotherapy for mesothelioma?
Immunotherapy has shown promise for treating mesothelioma, especially when patients haven’t responded to standard treatments like chemotherapy.
Some patients experience slower tumor growth, fewer symptoms, or smaller tumors. However, it doesn’t work for everyone. The specific type of immunotherapy, the stage of the cancer, and the mesothelioma cell type can all impact how well it works.
What is the life expectancy with immunotherapy for mesothelioma?
The average mesothelioma life expectancy with immunotherapy is 18.1 months for patients who receive Opdivo and Yervoy alone.
Clinical trials show that patients who receive combination immunotherapy with chemotherapy or surgery (an approach known as multimodal therapy) have longer life expectancies.
What is the success rate of immunotherapy for mesothelioma?
Here are some key points about the mesothelioma immunotherapy success rate:
- Combination immunotherapies such as Opdivo and Yervoy have shown higher response rates. In the CheckMate 743 trial, around 40% of patients responded to treatment, which means almost half of them had their tumors shrink or disappear.
- The CheckMate 743 trial showed a median overall survival of 18.1 months with the combination of Opdivo and Yervoy compared to 14.1 months with chemotherapy.
- For treatments using PD-1/PD-L1 inhibitors, patients usually go about 4-6 months progression-free before their cancer starts growing again.
These results highlight the potential of immunotherapy to significantly improve outcomes for mesothelioma patients, offering hope for extended survival and a better quality of life.
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