What Are Mesothelioma Monoclonal Antibodies?
Monoclonal antibodies (often called mAbs) are special proteins made in a lab to help the body fight mesothelioma.
They’re designed to find and attach to antigens, which are specific molecules or “markers” found on the surface of specific cells, including cancer cells. You can think of an antigen as a unique “flag” that helps the immune system tell one type of cell from another.
In mesothelioma, mAbs often look for an antigen called mesothelin. This is a protein found mostly on mesothelioma cells and rarely on normal cells. The antibody attaches to the mesothelioma cells to stop them from growing, cause them to die, or deliver cancer-fighting medicine directly to the tumor.
This type of treatment is considered a type of immunotherapy because it helps the immune system find and fight cancer more precisely.
Download our Free Mesothelioma Immunotherapy Guide to learn how treatments like monoclonal antibodies can strengthen your body’s fight against cancer.
How Do Monoclonal Antibodies Treat Mesothelioma?
Monoclonal antibodies act as targeted therapies by attaching to specific proteins on mesothelioma cells, helping the immune system find and destroy them. They can also block signals that allow tumors to grow and spread.
1. Boosting the Body’s Immune System
Some monoclonal antibodies help immune cells recognize mesothelioma by blocking proteins that allow cancer to hide from the immune system. This helps T cells made by the immune system attack cancer tumor cells more effectively.
Other antibodies attach to markers like mesothelin on the cell surface, tagging cancer cells so the body’s immune cells know to destroy them.
“These antibodies … may be promising candidates for monitoring and treating mesothelioma and other mesothelin-expressing cancers.”
2. Slowing Cancer Cell Growth
Some monoclonal antibodies stop signals that tell mesothelioma cells to grow and divide. Others block proteins that tumors use to build new blood vessels they need to survive (angiogenesis).
For example, a monoclonal antibody drug called bevacizumab (Avastin®) blocks VEGF, a protein that helps tumors form blood vessels. By cutting off this supply, bevacizumab can starve tumors and slow their growth.
Types of Monoclonal Antibodies for Mesothelioma Treatment
Different monoclonal antibodies work in different ways. Each one targets a unique protein on mesothelioma cells and plays a specific role in treatment.
Bevacizumab
Bevacizumab (Avastin®) works by binding to VEGF. This slows the growth of tumor cells by cutting off their blood supply. This monoclonal antibody for mesothelioma may also reduce proliferation (cancer spread).
Though first approved for colorectal cancer, it’s being studied in clinical trials for mesothelioma, often alongside chemotherapy. Doctors monitor for side effects like hypertension and bleeding.
Nivolumab
Nivolumab (Opdivo®) is a monoclonal antibody that targets PD-1, a protein that weakens T-cell activity. Blocking PD-1 helps the immune system attack mesothelioma cells more effectively.
The U.S. Food and Drug Administration (FDA) approved nivolumab for pleural mesothelioma when surgery isn’t an option. It’s often combined with ipilimumab to improve results in clinical trials.
Patients taking both drugs have shown longer survival. About 25% of patients remain alive after three years. This combination is now recommended as a first-line immunotherapy treatment after diagnosis in patients who don’t qualify for surgery.
Ipilimumab
Ipilimumab (Yervoy®) is a monoclonal antibody that targets CTLA-4, a protein that stops T-cells from killing cancer. Blocking CTLA-4 helps the immune system stay aggressive against tumor cells.
It’s used with nivolumab to treat malignant pleural mesothelioma, especially in patients who can’t have surgery. This combination boosts immune response through different pathways.
In one trial, the average patient survival time was over 18 months, and around 38% of patients saw tumors shrink. Results show promise for long-term immunotherapy use.
Pembrolizumab
Pembrolizumab (Keytruda®) is a monoclonal antibody that blocks PD-1, helping T-cells target and destroy mesothelioma cells. It’s classified as a PD-1 inhibitor.
In 2024, the FDA approved pembrolizumab with chemotherapy drugs like pemetrexed, cisplatin, and carboplatin for people with advanced pleural mesothelioma. In studies, patients who received this combination lived about 17 months on average. Doctors are continuing to study this treatment to see how well it works for different types of mesothelioma.
Use our Free Doctor Match to find a mesothelioma specialist who offers monoclonal antibody therapy and other cutting-edge treatments.
Who Is Eligible for Mesothelioma Monoclonal Antibodies?
Your mesothelioma doctor can recommend different tests to determine if monoclonal antibody treatments could benefit you.
Tests used to see how monoclonal antibodies can help include:
- Biopsy (removal of a cancer tissue sample)
- Flow cytometry (using lasers to distinguish cells from one another)
- Immunohistochemistry (using dyes to look for mesothelioma cells)
They look for biomarkers like PD-L1 or mesothelin on the surface of mesothelioma cell lines. Tests like these help confirm that you have mesothelioma and whether monoclonal antibodies will work in your case.
Additionally, these tests can establish which mesothelioma cell type you have. Epithelioid mesothelioma typically responds better to antibody treatments because its cancer cells are easier for the medicine to find and attack. The other cell types (sarcomatoid and biphasic) are tougher to treat because their cells hide better from the immune system.
Eligibility also depends on overall health. Patients must be able to tolerate immunotherapy and may need other treatments like chemotherapy or surgery.
What to Expect With Mesothelioma Monoclonal Antibodies Treatment
Monoclonal antibody treatment for mesothelioma is usually delivered through an IV infusion at a cancer center. Each infusion can take anywhere from about 30 minutes to a few hours.
Afterward, your care team may watch you for a short time to make sure you don’t have any reactions, such as fever, chills, or other side effects. Sometimes these side effects happen because the medicine is killing cancer cells. This process is called cytotoxicity, which means the drug is toxic to cancer cells.
How often you receive treatment depends on how you are responding, your overall health, and the specific medicine being used. Some treatments are given every 2 to 4 weeks.
Treatment may also happen in cycles. For example, you might get several infusions over a few months, followed by a short break so your body can rest and your doctors can see how well the treatment is working.
Your oncology team may also do special blood tests to check how active your immune cells are or how your cancer markers are changing. Based on these results, your doctors may adjust your treatment plan to help you get the best results possible.
Benefits of Mesothelioma Monoclonal Antibodies
For people with mesothelioma, monoclonal antibodies can help slow down the disease and may help patients live longer.
Some monoclonal antibodies help by boosting the body’s immune system to attack the cancer. For example, Opdivo and Yervoy helped pleural mesothelioma patients live for 4 months longer than those getting chemotherapy in the recent CheckMate743 trial.
Keytruda can also improve survival. In fact, using Keytruda and chemotherapy together allowed patients to live for an average of 1 year longer than patients who only got chemotherapy, according to the Journal of Thoracic Oncology.
Finally, monoclonal antibodies kill mesothelioma cells while causing less harm to healthy parts of your body. This is because they attach to unique markers found on mesothelioma cells.
Side Effects of Mesothelioma Monoclonal Antibodies
Monoclonal antibody treatments can cause side effects, especially early on. These are often mild and may feel like an allergic reaction.
Common side effects include:
- Chills
- Diarrhea
- Fever
- Headache
- Low blood pressure
- Nausea or vomiting
- Rash or skin irritation
- Tiredness or weakness
Most side effects go away after treatment or can be controlled with medication. In some cases, inflammation can occur in the lungs (pneumonitis), liver (hepatitis), intestines (colitis), thyroid, or skin. These are less common but may need medical attention.
Certain monoclonal antibodies can also cause side effects related to the specific proteins they target. For example, bevacizumab may cause high blood pressure, bleeding, delayed wound healing, blood clots, or kidney problems. Cetuximab may lead to more severe skin rashes.
Compared to chemotherapy, however, monoclonal antibodies usually have fewer serious side effects. Everyone’s experience is different, and your care team will monitor you throughout treatment to keep you safe and adjust your infusion schedule if needed.
Cost of Monoclonal Antibodies Targeted Therapy
Monoclonal antibody treatments for mesothelioma are expensive. On average, these therapies cost around $100,000 per year but could exceed $150,000 when combined with other oncology (cancer) drugs. These are among the highest-priced treatments in medicine today.
Treatment costs vary by drug, dosage, and whether it’s part of a combined treatment plan. Insurance may cover part of the cost, but out-of-pocket expenses can still be high.
If you’re interested in monoclonal antibodies for mesothelioma treatment, you should speak with a financial counselor or insurance advisor early. Some hospitals also offer patient assistance programs or access to clinical trials.
Learn if Monoclonal Antibodies Could Work for You
Monoclonal antibodies have shown promise in helping mesothelioma patients live longer and feel better during treatment. Several, like Yervoy, Opdivo, and Keytruda, are already approved for general use, and many more are being studied in ongoing trials.
You could qualify to receive a monoclonal antibody treatment after a mesothelioma diagnosis, depending on the specifics in your case. Ask your doctor if there’s an approved therapy you can access or a clinical trial you can join.
Mesothelioma Hope’s Patient Advocates can also help you by:
- Finding the most effective treatments
- Referring you to the best local cancer centers
- Matching you with nearby clinical trials
- Exploring financial compensation options to help cover medical costs
Download our Free Immunotherapy Guide or call (866) 608-8933 to get in touch with us right now.
Mesothelioma Antibody FAQs
Do monoclonal antibodies work immediately?
No, they usually take some time. In mesothelioma, these drugs don’t directly destroy cancer cells. Instead, they help your immune system recognize and fight them.
It can take several weeks or even a few months to see results on imaging scans or notice improvements in symptoms. Your doctors will monitor you closely to determine whether the treatment is working as intended.
How many times can you get monoclonal antibodies for mesothelioma?
That depends on the specific medication and how your body reacts. For mesothelioma, monoclonal antibodies like nivolumab and ipilimumab are usually given every 2 to 3 weeks. Treatment often continues for up to 2 years or until the cancer begins to grow again or side effects become too difficult to manage.
If you tolerate the medication well and it keeps your cancer stable or shrinks it, your care team may continue it for as long as it remains effective.
How much do monoclonal antibodies cost?
Monoclonal antibody treatments are expensive. Each infusion can cost $10,000 to $15,000 or more, and treatment may continue for many months.
Mesothelioma Hope can help you look into compensation options and financial assistance that may cover part of your treatment. Contact us today to get started.
Is there a downside to monoclonal antibodies for mesothelioma?
The main downside of monoclonal antibody treatment for mesothelioma is that your immune system can become overactive. This can cause immune-related side effects like inflammation in the lungs (pneumonitis), liver (hepatitis), intestines (colitis), thyroid, or skin. Most of these reactions are mild and respond well to medications like steroids, though serious effects are possible in rare cases.
Another downside is that monoclonal antibodies may not work for you. The treatment works best in patients whose tumors express certain proteins such as PD-L1, which your oncologist can test for before starting therapy.
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