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Mesothelioma Immunotherapy

Mesothelioma immunotherapy involves using medications that activate your body’s natural defense mechanism to target and destroy cancer cells. This treatment method can help slow down the progress of mesothelioma and increase life expectancy. Recent research has shown that combining immunotherapy with chemotherapy can lead to a 29% boost in life expectancy compared to chemotherapy alone.

Medically reviewed by: Mark Levin, MD

Last updated:

What Is Immunotherapy for Mesothelioma?

Mesothelioma immunotherapy is a medical treatment that uses the human body’s immune system to fight cancer.

Malignant mesothelioma cells can sometimes sneak past the body’s defenses and go undetected. Mesothelioma immunotherapy aims to stimulate the patient’s immune system to find cancer cells and destroy them.

Key Facts on Mesothelioma Immunotherapy

  • Nivolumab (Opdivo®) and ipilimumab (Yervoy®) are the only drugs approved as standard (first-line) treatments for mesothelioma.
  • Mesothelioma immunotherapy is usually given through an intravenous (IV) infusion.
  • Researchers are studying additional immunotherapy drugs for pleural and peritoneal mesothelioma in clinical trials.
  • In February 2024, the UV-1 cancer vaccine was granted Fast Track designation based on positive results when combined with immunotherapy. This means it may be approved for widespread use once clinical trials are completed.

Immunotherapy is typically used in combination with other treatments such as surgery, chemotherapy, and radiation therapy, depending on the stage of the patient’s mesothelioma cancer and other factors.

Arm yourself with knowledge and take the first step toward exploring mesothelioma immunotherapy options. Download our Free Doctor Questions Checklist now.

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How Does Immunotherapy Work on Mesothelioma?

Immunotherapy enhances the immune system’s ability to fight mesothelioma cancer more effectively.

It does this in two ways:

  1. Making the immune system stronger so it can better fight mesothelioma cells
  2. Identifying and attacking cancer-cell parts called receptors that help these cells hide from the immune system

Who Does Immunotherapy Work Best For?

Currently, Opdivo and Yervoy work best for patients diagnosed with pleural mesothelioma who aren’t eligible for surgery. At this point, tumors may have spread through the body and can’t be safely operated on.

However, patients may be able to benefit from other immunotherapy medications being tested in clinical trials for both pleural and peritoneal mesothelioma.

Active vs. Passive Mesothelioma Immunotherapy

There are two forms of mesothelioma immunotherapy treatment: active and passive.

  • Active immunotherapy: the patient’s immune system fights mesothelioma cells.
  • Passive immunotherapy: the patient receives lab-grown antibodies (proteins that protect against cancer) since their immune system can’t create them naturally.

Each approach to immunotherapy has its benefits and drawbacks. A mesothelioma specialist can tell you which therapy may be right for you.

How Can Immunotherapy for Mesothelioma Help Me?

The main benefit of mesothelioma immunotherapy is that it can potentially help improve your life expectancy.

Additional benefits of immunotherapy include:

  • It may increase the chance of remission (where all visible signs of cancer disappear).
  • It can prevent mesothelioma from spreading.
  • It can help your immune system fight cancer even after you’ve stopped treatment.
  • It may result in fewer and more mild side effects than chemotherapy treatments.

As additional research is collected about the benefits of immunotherapy, mesothelioma doctors hope that more patients may be able to access immunotherapy treatments and become long-term survivors.

“Immunotherapy has shown promise in supporting mesothelioma patients by boosting their own immune system to recognize and fight cancer cells. It’s like giving their body an extra set of tools to combat the disease more effectively.”

- Quote from Jenna Tozzi, RN, Mesothelioma Hope Director of Patient Advocacy

Immunotherapy Mesothelioma Success Rate

According to the U.S. Food and Drug Administration (FDA), patients with inoperable pleural mesothelioma who took Opdivo and Yervoy for 2 years had a median survival time of over 18 months. In comparison, patients who received chemotherapy drugs alone lived for about 14 months.

Additionally, 23% of the patients were alive 3 years after getting Opdivo and Yervoy, and 14% didn’t have their cancer spread. Even more impressive, 8 patients have had their cancer go into complete remission.

Immunotherapy for peritoneal mesothelioma is also showing success in clinical trials. A July 2021 study testing atezolizumab (Tecentriq®) plus bevacizumab (Avastin®) found that the 1-year survival rate was 85%, and 61% of patients didn’t have their cancer spread.

Another 2023 case study found that one peritoneal mesothelioma patient was able to achieve remission after being treated with pembrolizumab (Keytruda®).

See if immunotherapy can help you live longer — find a mesothelioma specialist today with our Free Doctor Match service.

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4 Types of Mesothelioma Immunotherapy

​​There are different types of immunotherapy treatments for mesothelioma. Each type uniquely targets cancer cells. Learn about the types of mesothelioma immunotherapy below.

1. Immune Checkpoint Inhibitors

T cells activate immune system cells when they encounter foreign cells called antigens. When this happens, special checkpoint proteins on T cells are deactivated. This stimulates an immune response, and the T cells destroy the foreign cells.

However, mesothelioma cells prevent these checkpoint proteins from deactivating, so the immune response never happens. Immune checkpoint inhibitors correct this by turning off checkpoint proteins to destroy the cancer.

Examples of checkpoint inhibitors used to treat mesothelioma include:

  • Atezolizumab (Tecentriq®)
  • Avelumab (Bavencio®)
  • Cemioimab (Libtayo®)
  • Durvalumab (Imfinzi®)
  • Ipilimumab (Yervoy®)
  • Nivolumab (Opdivo®)
  • Pembrolizumab (Keytruda®)

As of February 2024, Opdivo and Yervoy are the only immunotherapy drugs FDA-approved as first-line treatments for pleural mesothelioma. Researchers are studying other checkpoint inhibitors listed above as second-line (follow-up) treatments.

For example, a report published in The Lancet explored how Opdivo could be used as a second-line treatment. In a randomized study, some patients were given Opdivo while others were given a placebo (a substance that doesn’t have the active immunotherapy drug). Patients who received Opdivo lived over 3 months longer.

2. Cancer Vaccines

Mesothelioma vaccines work with the immune system to teach the body to destroy cancer cells. They do this by either editing a patient’s immune cells to better respond to cancer cells or by helping the patient’s immune cells more easily identify which cells are cancerous.

CRS-207, a cancer vaccine made with listeria — a type of bacteria — has helped some patients in clinical trials in combination with mesothelioma chemotherapy. Listeria is known to produce an immune response against a variety of cancers.

Norwegian biotech firm Targovax has also seen early signs of success in its ONCOS-102 trial. This trial tests mesothelioma vaccines in combination with standard chemotherapy in several patients. Contact our nurse advocates today to see if you can join a vaccine trial.

3. Monoclonal Antibodies

Monoclonal antibodies target a particular site inside a cancer cell, such as a protein or enzyme. Sometimes, antigens on the surface of a mesothelioma cell are also targeted. Monoclonal antibodies used in mesothelioma treatment include tremelimumab (Imjudo®) and amatuximab.

According to a recent phase II clinical trial, 90% of malignant pleural mesothelioma (MPM) patients treated with amatuximab plus the chemotherapy drugs pemetrexed and cisplatin showed stable disease (meaning their cancer tumors didn’t grow but also didn’t shrink).

4. Adoptive Cell Therapy

Adoptive cell therapy involves collecting and modifying a patient’s immune cells (typically T cells) outside the body before reintroducing them with a better ability to combat mesothelioma.

The most well-known example is CAR T cell therapy. This treatment involves drawing blood from the patient, extracting their T cells with a special machine, and genetically modifying them to carry special receptors called chimeric antigen receptors (CAR).

The modified CAR T cells are then given to the patient through an IV infusion to bind to antigens on mesothelioma cells and kill them.

Immunotherapy’s Role in the Future of Mesothelioma Treatment

Doctor consults with a patient about mesothelioma immunotherapy options

As mesothelioma treatment evolves, cancer immunotherapy is poised to play a key role in a larger multimodal treatment approach. Multimodal mesothelioma therapy is when multiple 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 the new standard of care.

Chemotherapy With Immunotherapy for Mesothelioma

Chemotherapy has been a mainstay of mesothelioma treatment for decades. It works by injecting patients with specific medication to help kill cancer cells that have spread (metastasized) to other body parts.

Many studies suggest combining chemotherapy and immunotherapy — known as chemoimmunotherapy — may be the best way to increase mesothelioma survival rates for patients whose cancer is unresectable (unable to be removed through surgery).

For example, the clinical trial PrE0505 treated patients with the immunotherapy drug (Imfinzi®) combined with cisplatin and pemetrexed chemotherapy. The study team found that patients who received chemoimmunotherapy had an overall survival time of 20.4 months. Historically, patients who receive chemotherapy alone have a life expectancy of 12.1 months.

“Combination immunotherapy represents a new standard of care for patients with unresectable malignant pleural mesothelioma….The combination of chemotherapy with immune checkpoint inhibitors likely represents the next step.”

- The Evolving Role of Immune-Checkpoint Inhibitors in Malignant Pleural Mesothelioma, Journal of Clinical Medicine, February 2023

The phase III DREAM3R trial compares (Imfinzi®) with cisplatin or carboplatin-pemetrexed chemotherapy with chemotherapy alone. The study is expected to be completed in 2025.

The best way to find out if you can join an immunotherapy clinical trial is to make an appointment with a mesothelioma doctor. Find a local specialist who can help using our Free Doctor Match.

Surgery With Immunotherapy

Immunotherapy can be used as an additional treatment before or after a patient has mesothelioma surgery to help the body recognize and fight off cancer cells that may try to grow back.

A 2022 Baylor College of Medicine clinical trial found that treating pleural mesothelioma patients with the immune checkpoint inhibitors Imfinzi and/or Imjudo about 3 weeks before surgery led to longer survival time. Additionally, 35.3% of the patients studied had their tumors shrink in size.

A phase II clinical trial is currently underway at Johns Hopkins University’s Sidney Kimmel Comprehensive Center, testing Opdivo and/or Yervoy before surgery in pleural mesothelioma patients. The final study results should be available in 2026.

Clinical Trials for Mesothelioma Video Thumbnail

Amy Fair, a nurse with over 20 years of mesothelioma experience, explains what clinical trials are, the types, and how to find them. View Transcript.

Duration: 1 min 31 sec

Besides the standard treatment right now of radiation, surgery, and chemotherapy there are ongoing clinical trials at some facilities that some patients may fit.

Clinical trials are the development of new and novel therapies.

You have to be a candidate and meet certain criterial for clinical trials. Some trials evolve around a certain type of mesothelioma. Some evolve around a certain age group.

There are exciting clinical trials out there now that involved immunotherapy, where they are strengthening and enhancing someone’s immune system to fight the disease. There are target and gene therapies currently in clinical trials that target someone’s DNA make up and molecular studies. These are still currently in several phases of clinical trials.

If you are interested in a clinical trial or your oncologist thinks you’re a candidate for a clinical trial the best way to learn is to start with your oncologist. They should be very knowledgeable about the clinical trials in your area. The National Institute of Health, on their website, has a tremendous amount of knowledge about clinical trials, the different phases that they are in and where these facilities are at that are involved in these clinical trials.

Side Effects of Immunotherapy For Mesothelioma

Side effects are unique to each patient and depend on the specific type of immunotherapy drug they receive.

Mesothelioma immunotherapy side effects can include:

  • Constipation or diarrhea
  • Fatigue
  • Flu-like symptoms
  • Heart palpitations
  • Nausea
  • Pain, itching, or inflammation

If you get mesothelioma immunotherapy through a clinical trial, you’ll be closely monitored for any side effects. Your doctor may choose to stop treatment if you have a serious reaction to a particular immunotherapy drug.

How Much Does Immunotherapy for Mesothelioma Cost?

According to an article in the medical journal Frontiers in Oncology, the combination of Opdivo and Yervoy can cost a patient over $292,000 annually. Reuters recently reported that other immune checkpoint inhibitors can cost $150,000 annually.

A mesothelioma specialist can help determine which types of immunotherapy (if any) you can receive and if your health insurance will cover some or all of the costs. For example, veterans who qualify for VA health care benefits may be able to access mesothelioma immunotherapy for free or at a reduced cost.

Find Doctors for Mesothelioma Immunotherapy Near You

When it comes to mesothelioma immunotherapy, having the right medical team by your side is crucial. Mesothelioma Hope can help you find doctors who have expertise in immunotherapy.

Seeing a mesothelioma specialist can help you receive the most current and effective treatments.

Your journey to hope and healing starts here — find mesothelioma doctors in your area now.

Mesothelioma and Immunotherapy FAQs

How successful is immunotherapy for mesothelioma?

Immunotherapy is very effective in treating mesothelioma and even more effective than chemotherapy in some cases.

According to a report published in JCO Oncology Practice, the median overall survival for patients with sarcomatoid or biphasic mesothelioma treated with immunotherapy was 18.1 months.

In comparison, patients with the same cell types who were treated with chemotherapy only lived for 8.8 months.

What are the pros and cons of immunotherapy for mesothelioma?

Mesothelioma immunotherapy has been shown to improve patient survival time and quality of life, whether used alone or in combination with other treatments.

However, some patients can experience side effects like inflammation, flu-like symptoms, and swelling.

Immunotherapy for mesothelioma can also be very expensive, even with insurance. Contact our team today to see if you may be able to receive financial aid to help pay for treatment.

What is the success rate of immunotherapy for mesothelioma?

Individual success rates with immunotherapy vary based on each patient’s type and stage of mesothelioma.

However, nivolumab (Opdivo®) and ipilimumab (Yervoy®) have shown to be very successful in treating patients with pleural mesothelioma tumors that can’t be removed with surgery.

According to updated trial results published in the May 2022 edition of Annals of Oncology, 8 of the 165 patients who received this immunotherapy treatment 3 years ago went into complete remission. None of the patients who received chemotherapy achieved remission.

What is the life expectancy of someone with immunotherapy for mesothelioma?

The median life expectancy with immunotherapy for mesothelioma is 18.1 months, according to results of the phase 3 CheckMate-743 clinical trial.

This is specifically for patients receiving nivolumab (Opdivo®) and ipilimumab (Yervoy®) together.

What drugs are used for immunotherapy for mesothelioma?

A combination of the drugs nivolumab (Opdivo®) and ipilimumab (Yervoy®) are used for mesothelioma immunotherapy. The treatment was approved by the U.S. Food and Drug Administration (FDA) in October 2020.

This immunotherapy combination has only been approved for patients with pleural mesothelioma who can’t receive surgery.

Dr. Mark LevinReviewed by:Mark Levin, MD

Certified Oncologist and Hematologist

  • Fact-Checked
  • Editor

Mark Levin, MD, has over 30 years of experience in academic and community hematology and oncology. In addition to serving as Chief or Director at four different teaching institutions throughout his life, he is still a practicing clinician, has taught and designed formal education programs, and has authored numerous publications in various fields related to hematology and oncology.

Dr. Mark Levin is an independently paid medical reviewer.

  • Board Certified Oncologist
  • 30+ Years Experience
  • Published Medical Author
Jenna TozziWritten by:

Director of Patient Advocacy

Jenna Tozzi, RN, is the Director of Patient Advocacy at Mesothelioma Hope. With more than 15 years of experience as an adult and pediatric oncology nurse navigator, Jenna provides exceptional guidance and support to mesothelioma patients and their loved ones. Jenna has been featured in Oncology Nursing News and is a member of the Academy of Oncology Nurse & Patient Navigators & the American Nurses Association.

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