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Two independent scientific studies show how immunotherapy for mesothelioma can benefit patients who have surgery.
Immunotherapy is a rising treatment option for cancer. The approach helps the patient’s immune system fight tumors in a natural way, like it would fight a common cold or viral infection.
Mesothelioma is a rare type of cancer the forms in the thin lining around the lungs, abdominal cavity and heart. The average survival is 1-2 years, and doctors hope to use immunotherapy as a way to lengthen survival rates and give patients more quality time with loved ones.
Doctors for mesothelioma are looking into whether immunotherapy can be a standard part of treatment plans – intertwined with surgery and chemotherapy, for example. These two recent studies incorporate immunotherapy into treatment plans before or after surgery.
Each study focused on a different type of mesothelioma: one on people with pleural mesothelioma; one on people with peritoneal mesothelioma. Pleural mesothelioma is the most common type of this cancer. Tumors start in the thin tissue lining of the lungs, which is called the pleura.
Peritoneal mesothelioma, which is much less common, starts in the thin lining of the abdominal cavity, which is called the peritoneum.
Immunotherapy Regimen Works for Pleural Mesothelioma
Dr. Joshua Reuss led a study at MedStar Washington Cancer Institute. Patients received the immunotherapy drug nivolumab (brand name Opdivo) before surgery. Some also received ipilimumab (Yervoy) before surgery, followed by chemotherapy and another regimen of Opdivo after surgery.
Opdivo and Yervoy are approved by the U.S. Food and Drug Administration to treat people with unresectable pleural mesothelioma (cases where surgery is not an option). They are immune checkpoint inhibitors, which means they block proteins on mesothelioma tumor cells from carrying out certain “checkpoints” that shut down the immune system. Blocking these tumor cell proteins keeps the immune system active and looking for cancer cells.
There’s already a scientific basis that this combination of immunotherapy helps the immune system against mesothelioma. The median survival for patients is 18 months when Opdivo and Yervoy are used with chemotherapy (no surgery).
In the study run at MedStar Washington Cancer Institute, patients who only received Opdivo before mesothelioma surgery had a median survival of 19.3 months. People who received Opdivo and Yervoy before surgery, plus Opdivo again after surgery, had a median survival of 28.6 months (2 years, 4 months).
Lesser-Known Immunotherapy Shines for Peritoneal Mesothelioma
Doctors tested “postoperative immunotherapy” in 70 people diagnosed with peritoneal mesothelioma. They all underwent cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC). Cytoreduction with HIPEC is the standard surgery for peritoneal mesothelioma.
Following surgery, they received chemotherapy and then were divided into two groups: one receiving immunotherapy and one not. The group that received immunotherapy had such a longer median survival that it actually had not been reached by the time the study results were published. The median survival not being reached means some of the patients were still alive, possibly enjoying long-term remission and survival.
The group not receiving immunotherapy had a median survival of 28.4 months (2 years, 4 months). While this is better than how many patients with peritoneal mesothelioma fare, it is not considered long-term survival.
In the immunotherapy group, the drug sindilizumab performed better for patients than camrelizumab (brand name AiRuiKa). Sindilizumab also performed better than pembrolizumab (Keytruda) and the combination of Opdivo with Yervoy.
Sindilizumab is not often tested as an immunotherapy for mesothelioma, so this study could lead to further testing.
Sources & Author
- Perioperative nivolumab or nivolumab plus ipilimumab in resectable diffuse pleural mesothelioma: a phase 2 trial and ctDNA analyses. Nature Medicine. Retrieved from: https://www.nature.com/articles/s41591-025-03958-3. Accessed: 09/11/2025.
- Efficacy of postoperative immunotherapy on MPM patients after CRS + HIPEC: A single-center retrospective study based on propensity score matching. International Journal of Cancer. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/40891423/. Accessed: 09/11/2025.
Sources & Author
