What Is Immunotherapy for Mesothelioma?
Mesothelioma immunotherapy uses medications to help the body’s own immune system fight malignant mesothelioma.
Immunotherapy for mesothelioma aims to teach the body to recognize harmful cancer cells, prevent cancer from decreasing immune response, and/or help the body’s immune system kill cancer cells.
Quick Facts About Mesothelioma Immunotherapy
- The Food and Drug Administration (FDA) approved nivolumab (Opdivo®) plus ipilimumab (Yervoy®) as a first-line treatment for metastatic non-small cell lung cancer in October 2020.
- 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 qualifying 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 inventors of immunotherapy for cancer, marking just how promising this new cancer treatment is.
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Benefits of Immunotherapy for Mesothelioma
Immunotherapy has already helped many cancer patients overcome their disease. Now, the benefits of this innovative mesothelioma treatment are being used to help more patients than ever before.
Immunotherapy for mesothelioma aims to destroy cancer cells, while mesothelioma chemotherapy also kills healthy cells. However, immunotherapy can also cause serious side effects.
Because it only targets cancer cells, mesothelioma immunotherapy has fewer side effects compared to more aggressive cancer treatments such as chemotherapy or radiation therapy.
Mesothelioma immunotherapy may also increase the chance of remission. Since the body is recognizing and destroying cancer cells, there is a higher chance the immune system will prevent the cancer from returning after treatment (recurrence).
As doctors continue to make immunotherapy advances for mesothelioma treatment, there is hope that more patients may be able to access these benefits and improve overall survival.
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Mesothelioma Prognosis After Immunotherapy
Cancer immunotherapy may improve mesothelioma prognosis, or the general course doctors expect a patient’s mesothelioma to take. Mesothelioma often has a positive response to immunotherapy methods.
As noted by the Food and Drug Administration (FDA), unresectable malignant pleural mesothelioma patients who received nivolumab (Opdivo®) and ipilimumab (Yervoy®) over a two-year period had a median survival time of over 18 months, while patients who were treated with just chemotherapy lived for roughly 14 months.
Further, a July 2021 clinical trial testing atezolizumab (Tecentriq®) plus bevacizumab (Avastin®) as a treatment for peritoneal mesothelioma patients found about 85% of patients experienced a survival rate of over one year and 61% of patients were progression-free.
Mesothelioma research continues to find immunotherapy to be effective in improving mesothelioma prognosis. More immunotherapy treatments may become available as oncology research moves forward.
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.
Types of Immunotherapy for Mesothelioma
There are several different types of immunotherapy treatment of mesothelioma. Each method targets cancer cells in a different way. It is important to speak with your mesothelioma specialist to learn which type of immunotherapy (if any) is best for you.
As of 2020, only the immune checkpoint inhibitors Opdivo® and Yervoy® for pleural mesothelioma are FDA approved. You may be able to access other types of immunotherapy off-label or through clinical trials.
Learn more about the different types of immunotherapy for mesothelioma below.
Cancer Vaccines
Mesothelioma vaccines work with the immune system to teach the body to destroy 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 also working on preventative mesothelioma vaccines. CRS-207 is a listeria (bacteria) 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.
Cytokines
Cytokines are proteins that help the body increase the immune response to cancer cells and sometimes are grown in a lab.
Some cytokines help immune system cells grow more quickly, while others help the body resist cancer cells.
Immune Checkpoint Inhibitors
Immune checkpoint inhibitors prevent cancer cells from hiding from the body’s immune system. This type of immunotherapy for mesothelioma targets certain proteins in cancer cells, referred to as checkpoints. The checkpoints targeted by mesothelioma immunotherapies include CTLA-4, PD-L1, and PD-1.
Some checkpoint inhibitors used to treat mesothelioma include:
- Atezolizumab (Tecentriq®)
- Avelomab (Bavencio®)
- Cemioimab (Libtayo®)
- Durvalumab (Imfinzi®)
- Ipilimumab (Yervoy®)
- Nivolumab (Opdivo®)
- Pembrolizumab (Keytruda®)
Monoclonal Antibodies
Monoclonal antibodies work by targeting a particular site inside of a cancer cell, such as a protein or enzyme. Sometimes antigens on the surface of a cancer cell are also targeted.
Monoclonal antibodies used to treat mesothelioma include tremelimumab and amatuximab. According to a 2014 phase II clinical trial, 90% of malignant pleural mesothelioma patients treated with amatuximab plus the chemotherapy drugs pemetrexed and cisplatin showed stable disease rate.
Other Types of Immunotherapy for Mesothelioma
There are several other types of immunotherapy for mesothelioma being tested for effectiveness.
One type of immunotherapy being studied for mesothelioma involves immunomodulators. These drugs work with the immune system to increase some types of proteins and decrease other types.
Some types of immunomodulators include lenalidomide, pomalidomide, and thalidomide.
Other immunotherapies 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.
- ONCOS-102: This type of immunotherapy was recently fast-tracked by the FDA for mesothelioma.
Mesothelioma Immunotherapy in Multimodal Therapy
Multimodal therapy is a very common method to treat mesothelioma patients. Mesothelioma specialists will often use mesothelioma immunotherapy alongside other treatments like chemotherapy, virotherapy, and surgery.
Learn more about immunotherapy multimodal treatment combinations below.
Chemotherapy and Immunotherapy
Cancer research has found 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 cancers are able to make themselves invisible to the immune system. While the chemotherapy fights off cancer, active immunotherapy teaches the immune system to recognize cancer cells as harmful.
Surgery and Immunotherapy
Immunotherapy for mesothelioma can be used as an adjuvant or additional therapy after a patient has undergone 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 mesothelioma virotherapy, viruses are altered to duplicate themselves better inside tumor cells than in healthy cells. Then, immunotherapy can be used to go where the virus is and target cancer cells.
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Side Effects of Immunotherapy For Mesothelioma
There are several side effects of immunotherapy for mesothelioma, but these are considered more mild compared to other forms of treatment. The side effects may be different for each person and depend on the specific type of immunotherapy being given.
Some possible immunotherapy side effects include:
- Changes in blood pressure
- Flu-like symptoms such as fever, chills, nausea, and congestion
- Heart palpitations
- Inflammation of pleural, peritoneal, or pericardial surfaces or inflammation in other organs due to immune response
- Pain, itching, burning, or inflammation near the injection site
- Weight gain due to extra fluid in the body
- Trouble breathing, tiredness, dizziness, or muscle pains
Since some of these treatments are new and you may encounter them while participating in a clinical trial, all side effects will be monitored closely.
Your doctor can help determine which symptoms you may encounter and which treatment options will be best for you based on possible side effects.
Find Immunotherapy for Mesothelioma Today
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 recent approval of Opdivo and Yervoy, more patients may be able to improve their mesothelioma life expectancy. Other immunotherapy options for mesothelioma continue to be studied.
Patients who are looking to use immunotherapy to help treat their mesothelioma should speak with a mesothelioma doctor.
Use our Mesothelioma Doctor Match to connect with a doctor near you today.
Immunotherapy for Mesothelioma FAQs
What is the success rate of immunotherapy for mesothelioma?
Many types of mesothelioma immunotherapy are still being tested in clinical trials and are evolving.
However, the combination of nivolumab (Opdivo) plus ipilimumab (Yervoy) has proven successful in treating malignant pleural mesothelioma and was approved for mainstream use in October 2020.
The clinical trial found after two years, 41% of patients treated with Opdivo and Yervoy were still alive compared to 27% of patients treated with chemotherapy.
How does mesothelioma immunotherapy work?
The goal of mesothelioma immunotherapy is for the body to better recognize, fight, and destroy cancer cells.
Immunotherapy differs from other cancer treatments because it only targets harmful cancer cells, not healthy cells. Still, it can provoke inflammation that can hurt normal cells.
How much does immunotherapy for mesothelioma cost?
Mesothelioma immunotherapy costs can vary. According to Reuters, Opdivo plus Yervoy can cost around $256,000 each year. Reuters also notes other immune checkpoint inhibitors can run around $150,000 each year.
It is important to consult with your doctor to determine your options for mesothelioma immunotherapy and whether your health insurance will cover the cost of care.
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How do you know if immunotherapy is working?
Your specialist will look for several signs that indicate the body is responding positively to immunotherapy for mesothelioma. It is important to note that this treatment works slower than chemotherapy.
According to Moffitt Cancer Center, shrinking or stable tumor size is an indication the mesothelioma immunotherapy is working. Your doctor may conduct laboratory and imaging tests to check in on the progress of the tumor during treatment.
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