A lot of doctors believe in using immunotherapy for malignant peritoneal mesothelioma.

Now a clinical trial in the United States will put it to practice on a large scale.

A new clinical trial published on the Clinical Trials website in September. It’s at the University of Chicago Comprehensive Cancer Center. The study is not yet recruiting but will open soon for patients with peritoneal mesothelioma. The estimated start date for the trial is Jan. 1, 2022.

If you have this diagnosis, contact our patient advocates. We can help you apply for this trial or another one involving peritoneal mesothelioma. Email karen@mesotheliomaguide.com to talk with our registered nurse, Karen Ritter.

 

Opdivo and Yervoy Growing in Popularity

Opdivo and Yervoy for mesothelioma is a focus of most cancer centers and doctors. The U.S. Food and Drug Administration (FDA) approved the drugs a year ago for unresectable pleural mesothelioma.

Opdivo (nivolumab) and Yervoy (ipilimumab) are immune checkpoint inhibitors. They block specific protein receptors on T‑cells and cancer cells to help the immune system fight cancer.

Mesothelioma immunotherapy treatment comes in many forms, but the most popular are these immune checkpoint inhibitors. They show the best outcomes for survival and benefit the largest population of patients.

Most specialists for peritoneal mesothelioma vouch for immunotherapy as a second‑line option if chemotherapy fails. Others say it could be a first‑line option in place of chemotherapy. Most doctors limit their use of Opdivo and Yervoy to non‑surgery cases, though.

This trial may open more doors and minds, giving patients a better chance at longer survival.

 

Immunotherapy Before and After Surgery

This new clinical trial will give up to 37 patients Opdivo and Yervoy before and after surgery. For peritoneal mesothelioma, the surgery is cytoreduction/HIPEC. The HIPEC portion is hyperthermic intraperitoneal chemotherapy.

The participants will receive Opdivo and Yervoy for a year and a half. The measurements are:

  • Tumor response
  • Serious side effects
  • Ability to do surgery after neoadjuvant immunotherapy
  • Overall survival and progression‑free survival

The results should give indication to whether immunotherapy works for peritoneal mesothelioma. Many doctors feel the progress from pleural mesothelioma will transfer.

Chemotherapy usually leads to survival of 8‑16 months for pleural mesothelioma. In the Checkmate‑743 trial, the survival average was 14 months. Immunotherapy surpassed the time with 18‑19 months.

 

History of Peritoneal Mesothelioma Studies With Immunotherapy

This isn’t the first attempt to use immunotherapy for peritoneal mesothelioma. Doctors at MD Anderson Cancer Center (Houston, Texas) used atezolizumab and bevacizumab. Atezolizumab is an immune checkpoint inhibitor, and bevacizumab is a VEGF‑blockade drug. The median survival was 17‑18 months.

MD Anderson also hosted a trial involving Opdivo and Yervoy for advanced peritoneal mesothelioma. The median survival was 19 months, which is promising. This study only involved “diffuse” cases of the cancer, so they likely didn’t combine it with surgery. The trial at the University of Chicago is different due to pairing immunotherapy with surgery.

Doctors at Rutgers Cancer Institute also tested the volume of PD‑L1 on the surface of peritoneal mesothelioma tumors. This test checks how effective drugs like Opdivo and Yervoy are for patients. Tumors with low amounts of PD‑L1 might not be affected by these two choices.

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