Durvalumab and tremelimumab work so well together for mesothelioma that most patients in a study are still alive two years after starting treatment.
Baylor College of Medicine, affiliated with Baylor St. Luke’s Medical Center, hosted a phase 1 clinical trial with 20 patients. Sixteen received at least one of the immunotherapy drugs for mesothelioma. Eight of them received durvalumab – called MEDI4736 – and tremelimumab. Eight received just durvalumab. Four didn’t receive any treatment.
The median survival for durvalumab for mesothelioma alone was 14 months – same as progression-free survival. The survival time for durvalumab and tremelimumab was not available, but for a promising reason.
Five of the eight patients completing immunotherapy treatment were still alive at the check-up. Since there was more than 50% survival in the group, the median survival and median progression-free survival couldn’t be calculated.
Past Success With Durvalumab and Tremelimumab
A phase 2 study involving these drugs resulted in a median survival of 16 months. This proved the two drugs work in tandem.
Durvalumab, the generic name for Imfinzi, is a PD-1/PD-L1 checkpoint inhibitor. It blocks the connection of a T-cell receptor and cancer cell receptor. Blocking the receptors helps the immune system.
Tremelimumab is a CTLA-4/B7 checkpoint inhibitor, performing the same action for these receptors. The two immunotherapies work similarly to nivolumab and ipilimumab, called Opdivo and Yervoy and approved by the U.S. Food and Drug Administration for mesothelioma.
Can Durvalumab and Tremelimumab Get Approved?
The DREAM study used durvalumab with chemotherapy. The survival of 20 months, on median, supported a phase 3 trial called DREAM3R. The new trial is enrolling patients at many cancer centers.
If durvalumab with tremelimumab can outperform durvalumab and chemotherapy, then it may get approved by the FDA.
What this Baylor College of Medicine study proves is durvalumab works best with another drug: either chemotherapy or another immune checkpoint inhibitor. Durvalumab seems close to approval in some form for malignant mesothelioma. The variable left to answer is the best combination.
If you’re a mesothelioma patient or loved one of a patient, you should ask about enrolling in immunotherapy clinical trials. Some of these trials include durvalumab, while others feature pembrolizumab or nivolumab, to name just a few immunotherapies showing promise. Email our registered nurse, Karen Ritter, to get guidance in finding a cancer center with clinical trials. She’s reachable at firstname.lastname@example.org.
Sources & Author
- MEDI4736 Or MEDI4736 + Tremelimumab In Surgically Resectable Malignant Pleural Mesothelioma. Clinicaltrials.gov. Retrieved from: https://clinicaltrials.gov/ct2/show/study/NCT02592551. Accessed: 01/20/2022.