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Cost Comparison of Immunotherapy vs. Traditional Chemotherapy in Mesothelioma

Cost Comparison of Immunotherapy vs. Traditional Chemotherapy in Mesothelioma

A new study does a cost comparison of immunotherapy over traditional chemotherapy. Immunotherapy and chemotherapy are common in the first-line treatment of malignant pleural mesothelioma.

The news came from Therapeutic Advances in Medical Oncology.

Traditional Chemotherapy

In 2004, the FDA approved pemetrexed for the treatment of malignant pleural mesothelioma. Pemetrexed is often taken together with cisplatin. It is for patients whose disease is either inoperable or who are not candidates for surgery.

Pemetrexed + cisplatin/carboplatin are chemotherapy drugs. Chemotherapy is a group of toxic drugs that kill cells by damaging their DNA. They target both cancerous and healthy cells.

Patients with this chemo regimen also take folic acid and vitamin B12 supplements. This helps to reduce side effects from the chemotherapy. Patients are usually prescribed corticosteroids to reduce the risk of skin rashes.


A few years ago, the FDA approved the combination of nivolumab + ipilimumab. Immunotherapy is a type of cancer treatment. It uses the patient’s immune system to fight cancer. Immunotherapy is also referred to as biological therapy.

This is a combination of immunotherapy drugs that complement each other. Both drugs are immune checkpoint inhibitors. They are approved to treat people with inoperable pleural mesothelioma.

It is the first-line treatment for patients with metastatic non-small cell lung cancer. It attempts to stimulate an immune response in the patient’s body to fight cancer. Several of these approaches continue to provide a long-term survival benefit in mesothelioma.

No Cost Advantage

A new study evaluated the cost comparison of these two treatments. They compared immunotherapy (nivolumab + ipilimumab) versus chemotherapy (pemetrexed + cisplatin/carboplatin).

The team used data from a 10-year period. The data came from the CheckMate 743 clinical trial. CheckMate 743 was a multicenter, randomized, open-label, phase III trial.

Results showed that immunotherapy has no cost advantage over traditional chemotherapy. Nivolumab + ipilimumab has no cost advantage over pemetrexed + cisplatin/carboplatin.

This is true for US payers and patients with unresectable malignant pleural mesothelioma.


Yang, Liu, Xueqiong Cao, Na Li, Bin Zheng, Maobai Liu, and Hongfu Cai. “Cost-effectiveness analysis of nivolumab plus ipilimumab versus chemotherapy as the first-line treatment for unresectable malignant pleural mesothelioma.” Therapeutic advances in medical oncology 14 (2022): 17588359221116604. https://doi.org/10.1177%2F17588359221116604

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