There may be new hope for malignant mesothelioma patients whose cancer recurs after treatment.
A presentation at the recent World Lung Cancer conference in Vienna earlier this month suggests that the immunotherapy drug nivolumab (brand name Opdivo) could help people with pleural mesothelioma who have run out of treatment options.
The author of the new study says his Amsterdam-based team has recorded mesothelioma survival of more than a year after treatment with nivolumab.
What is Nivolumab
Nivolumab is a monoclonal antibody designed to block a cell surface protein called PD-1. As a result of blocking this protein, the body’s immune system is better able to attack the mesothelioma with antitumor T-cells.
PD-1 is believed to be expressed by up to 40 percent of mesothelioma tumors and PD-1 inhibitors like nivolumab seem to work better in these patients..
Nivolumab has been found to extend survival in people with non-small cell lung cancer who have previously been treated with platinum-based chemotherapy. The research team was hopeful that the same would be true for previously-treated mesothelioma patients.
Results of the Study
In the study presented in Vienna, nicknamed the Nivo-Mes trial, 38 patients with malignant pleural mesothelioma received 3 mg/kg of nivolumab every 2 weeks.
After 12 weeks on nivolumab, twelve of the mesothelioma patients experienced stable disease, meaning that their mesothelioma tumors temporarily stopped growing. In five other patients, their mesothelioma tumors actually shrank slightly.
Importantly, none of the mesothelioma patients died as a result of the treatment, although eight patients did end up stopping the treatment because of side effects. Most of the mesothelioma patients who responded to nivolumab had the epithelioid subtype of malignant mesothelioma.
Researchers at the Netherlands Cancer Institute where the trial was conducted say they plan to continue to research nivolumab for the treatment of mesothelioma.
“Nivolumab in second or later lines in recurrent malignant pleural mesothelioma met the primary endpoint,” study author Paul Baas, MD, PhD, said in a statement. “We detected mild toxicity, long lasting results, and we observed a clear correlation between PD-L1 expression and response.”
Other Immune Checkpoint Inhibitors in the News
Pembrolizumab (Keytruda) and avelumab are two other PD-1/PD-L1 inhibitors that made headlines in the treatment of mesothelioma in 2016.
The KEYNOTE trial of pembrolizumab, which included 25 malignant pleural mesothelioma patients, found a 20 percent overall response rate and a medium response duration of a year.
Avelumab produced a mesothelioma control rate of 56.6% with 5 out of 53 patients seeing a reduction in mesothelioma tumor size and another 25 experiencing stable disease.
“Nivolumab Shows Promise in Treating Malignant Pleural Mesothelioma”, International Association for the Study of Lung Cancer, News Release, December 7, 2016