Three years after the last patients enrolled in the clinical trial of Yervoy and Opdivo for mesothelioma, survival results still look promising for this immunotherapy treatment.
Researchers presented an update of the CheckMate 743 trial at the recent virtual conference of the European Society for Medical Oncology (ESMO). The team found that more than 23% of patients on Yervoy and Opdivo for mesothelioma were still alive at three years. Only 15% of the chemotherapy group were still living.
Immunotherapy for Malignant Mesothelioma
Alimta (pemetrexed) was the first drug to receive FDA approval for mesothelioma chemotherapy. The FDA approved it in 2004.
Before Alimta, patients had even fewer options that they do today. Most mesothelioma patients now start treatment with a combination of Alimta and a platinum drug like cisplatin or carboplatin.
But Yervoy and Opdivo for mesothelioma was a breakthrough. The FDA approved the combination for first-line treatment of pleural mesothelioma in October 2020. It was the first new drug treatment approved for mesothelioma in 15 years.
The FDA based the approval on the results of the CheckMate 743 trial. Researchers showed how Yervoy (ipilimumab) and Opdivo (nivolumab) work together to fight mesothelioma. One increases the number of cancer-killing immune cells in a tumor and the other makes cancer cells more susceptible to attack.
Updated Results on Yervoy and Opdivo for Mesothelioma
The CheckMate 743 trial of Yervoy and Opdivo for mesothelioma involved 605 patients from 103 hospitals around the world. All patients had unresectable pleural mesothelioma. Researchers randomly assigned patients to receive either the immunotherapy drugs or standard chemotherapy.
The combination worked especially well for people with the non-epithelioid subtype of mesothelioma. These people do not usually respond well to chemotherapy. But with the immunotherapy regimen, non-epithelioid patients had a median overall survival of 18.1 months. Non-epithelioid patients on chemotherapy survived for a median of just 8.8 months.
It has now been at least three years since the last CheckMate 743 patients received treatment in 2018. The researchers presented an update at ESMO’s virtual conference last week.
Twenty-three percent of those who received Yervoy and Opdivo for mesothelioma lived for at least three years. This was true even though patients had been off the therapy for a year. The chemotherapy group had a 3-year overall survival of 15.2 percent.
“With an additional 12 months of follow-up, these data from CheckMate743 confirm that nivolumab/ipilimumab is the standard of care for unresectable mesothelioma, regardless of histology,” said lead study author Solange Peters, MD, PhD. Dr. Peters is head of the Medical Oncology Service and chair of Thoracic Oncology in the Oncology Department at Lausanne University Hospital in Switzerland.
The study also suggested that mesothelioma patients with a certain combination of genes linked to inflammation survived longer than other patients.
Peters, S, et al, LBA65 – First-line nivolumab (NIVO) plus ipilimumab (IPI) vs chemotherapy (chemo) in patients (pts) with unresectable malignant pleural mesothelioma (MPM): 3-year update from CheckMate 743, ESMO Virtual Conference presentation, https://oncologypro.esmo.org/meeting-resources/esmo-congress-2021/first-line-nivolumab-nivo-plus-ipilimumab-ipi-vs-chemotherapy-chemo-in-patients-pts-with-unresectable-malignant-pleural-mesothelioma-mpm
Hergert, J, “Frontline Nivolumab/Ipilimumab Maintains OS Benefit Across Subgroups in Unresectable Malignant Pleural Mesothelioma”, September 17, 2021, OncLive, https://www.onclive.com/view/frontline-nivolumab-ipilimumab-maintains-os-benefit-across-subgroups-in-unresectable-malignant-pleural-mesothelioma