Avelumab May Offer a Second-Line Option for Recurrent Mesothelioma

People with recurrent mesothelioma may get another chance at treatment with the immunotherapy drug avelumab.

Malignant mesothelioma is highly resistant to standard cancer therapies. That means that the asbestos cancer usually comes back, or recurs, even after treatment.

The most common treatment for mesothelioma is chemotherapy with Alimta. Alimta is the only drug approved specifically for mesothelioma. Patients with recurrent mesothelioma often have several rounds of chemotherapy with Alimta.

But once the standard mesothelioma treatments stop working, patients do not have many options.

Now a new study suggests that some cases of recurrent mesothelioma that stop responding to Alimta may respond to avelumab.  

Considering Avelumab for Recurrent Mesothelioma

Bavencio is the brand name for avelumab. It is a type of immunotherapy drug called a monoclonal antibody. Bavencio targets a protein called programmed death-ligand 1 (PD-L1).

PD-L1 helps mesothelioma cells “hide” from the immune system.

The FDA originally approved Bavencio to treat non-small-cell lung cancer. It has since been approved to treat stomach cancer and a certain kind of skin cancer, too.

The National Cancer Institute ran the new study on Bavencio for mesothelioma. It included patients with recurrent mesothelioma from 25 sites in three countries. They were all diagnosed between September 2014 and July 2015.

Fifty-three patients received Bavencio. Thirty-eight percent of them already had three or more other kinds of mesothelioma treatments.

They got 10 mg/kg of Bavencio every two weeks until their mesothelioma came back or until they got too sick to continue.

Avelumab Deemed Safe and Effective as Second-Line Treatment

Researchers monitored the recurrent mesothelioma patients in this study for a median of two years.

Sixty-seven percent of patients responded well to Bavencio. In one patient, the drug wiped out their mesothelioma tumor. Four other patients saw their tumors shrink.

For fifty-eight percent, their recurrent mesothelioma stopped growing. It took a median of four months for mesothelioma tumors to start growing again after treatment with Bavencio.

Forty-three percent of patients were still alive a year after treatment.

Only 8 patients had a serious side effect either from the treatment or from its impact on their immune system. There were no treatment-related deaths.

“Avelumab showed durable antitumor activity and disease control with an acceptable safety profile in a heavily pretreated cohort of patients with mesothelioma,” concludes the report.

About 3,000 people contract mesothelioma in the US each year. Most do not live longer than a year.

Source:

Hassan, R, et al, “Efficacy and Safety of Avelumab Treatment in Patients With Advanced Unresectable Mesothelioma: Phase 1b Results From the JAVELIN Solid Tumor Trial”, January, 3, 2019, JAMA Oncology, Epub ahead of print, https://jamanetwork.com/journals/jamaoncology/fullarticle/2719756