According to clinical trial Checkmate 743, mesothelioma immunotherapy drugs nivolumab (Opdivo) and ipilimumab (Yervoy), when taken together, result in a higher quality of life compared to chemotherapy drugs pemetrexed and cisplatin or carboplatin. The study’s patient-reported outcomes, which reveal the success of immunotherapy, were recently reported.

At its original publication, Checkmate 743 revealed a higher survival rate in patients receiving Opdivo and Yervoy than those receiving chemotherapy. The average survival rates found for immunotherapy and chemotherapy were 18 months and 14 months respectively. Due to the study’s findings that immunotherapy has a better effect on the quality of life than chemotherapy, immunotherapy should continue to be on the rise as the prime treatment when surgery isn’t possible. 

 

What Is Immunotherapy?

Immunotherapy helps the immune system properly fight against diseased cells by strengthening immune cells, such as T cells. Cancers like mesothelioma overpower or trick the immune system, which allow the cancer to spread.

Currently, there are only two immunotherapy drugs approved by the FDA to treat pleural mesothelioma – Opdivo and Yervoy. Sometimes referred to by their generic names (nivolumab and ipilimumab), Opdivo and Yervoy are generic checkpoint inhibitor immunotherapy drugs. 

Opdivo is a checkpoint inhibitor for the connection between two proteins, PD-1 and PD-L1, blocking the link between the two. Keeping the proteins separate initiates a proper immune response when T cells recognize mesothelioma cells. 

Yervoy is also a checkpoint inhibitor for CTLA4 and B7 and poses as a barrier for the two, while enhancing T cells. The two enhance one another when used together to treat mesothelioma and other thoracic cancers, such as lung cancer.

 

How Does Immunotherapy Compare to Chemotherapy?

The objective of Checkmate 743 was to test the effects of immunotherapy drugs versus chemotherapy on patients with unresectable pleural mesothelioma. The study assigned 605 participants to randomized groups: A and B. Group A consisted of immunotherapy (a combination of Opdivo and Yervoy), and Group B involved chemotherapy (pemetrexed and either cisplatin or carboplatin). 

The mesothelioma clinical trial began in November of 2016 and continues to be monitored closely, taking several factors into account – quality of life, lung cancer symptoms, symptom burden and others. 

Of the concluded results for patient-reported outcomes, Opdivo and Yervoy had significant effects on pleural mesothelioma patients compared to chemotherapy. Throughout the study, the overall condition of the patients who received immunotherapy improved over time. Patients receiving chemotherapy saw their overall condition improve for a short period of time and then decline as the trial continued. 

Common symptoms associated with pleural mesothelioma are chest pain, pleural effusions (fluid buildup in the pleura), painful breathing and a persistent cough. Of these, immunotherapy was found to diminish all symptoms except cough, while chemotherapy appeared to cause deterioration in patients and their quality of life. 

Quality of life was one of the critical measurements of success for Checkmate 743. Immunotherapy proved to be more effective in enhancing quality of life, in addition to tumor response. Patients who received immunotherapy drugs showed long-term effects against pleural mesothelioma tumors. Their cancer continued to shrink as a direct result from the immunotherapy.

Patients who received chemotherapy saw more short-term results. Their cancer appeared to shrink but not at the rate patients in immunotherapy experienced. This data proves immunotherapy as the most effective treatment for patients with unresectable pleural mesothelioma.

 

    Sources & Author

     

    First-line nivolumab plus ipilimumab versus chemotherapy for the treatment of unresectable malignant pleural mesothelioma: patient-reported outcomes in CheckMate 743. National Library of Medicine. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/35367910/. Accessed: 04/06/2022. 

     

Camryn Keeble image

About the Writer, Camryn Keeble

Camryn Keeble is a content writer and community outreach member for Mesothelioma Guide. She creates mesothelioma-related content for the Mesothelioma Guide website. Camryn's goal is to decipher advanced information regarding mesothelioma into informative, simplified content to educate those affected by mesothelioma. She also works diligently to raise awareness of mesothelioma and its effects on patients and their loved ones by participating in daily outreach.

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    Sources & Author

Picture of Camryn Keeble

About the Writer, Camryn Keeble

Camryn Keeble is a content writer and community outreach member for Mesothelioma Guide. She creates mesothelioma-related content for the Mesothelioma Guide website. Camryn's goal is to decipher advanced information regarding mesothelioma into informative, simplified content to educate those affected by mesothelioma. She also works diligently to raise awareness of mesothelioma and its effects on patients and their loved ones by participating in daily outreach.