Mesothelioma specialists at two of the top mesothelioma cancer centers are collaborating on a study to determine the ideal way to treat patients with a multimodal plan that includes surgery.
The study will be held at two mesothelioma cancer centers of excellence, Baylor St. Luke’s Medical Center and Duke University Health System. Both hospitals have highly regarded mesothelioma doctors on their staff.
The clinical trial will test whether it’s more effective for survival and quality of life to treat patients with chemotherapy and immunotherapy before surgery or just chemotherapy before surgery. The first group is also called “chemoimmunotherapy,” which is a common term for using chemotherapy and immunotherapy together.
Comparing Chemotherapy and Immunotherapy
This study will be a valuable test of whether immunotherapy for mesothelioma enhances the effectiveness of chemotherapy and surgery. In past studies, immunotherapy has helped patients live for an average of 16 months, which is slightly better than the average survival for patients receiving mesothelioma chemotherapy, but the 3-year survival rate with immunotherapy is just 23%. There isn’t much data showing whether these two treatment options should be used together – or how they impact patient survival after surgery.
Mesothelioma is a rare cancer – only an estimated 2,500 people are diagnosed each year – and it almost always forms in the small lining of the lungs or abdomen. Mesothelioma that forms near the lungs is called pleural mesothelioma, which is the focus of this study and has an average survival of 12-16 months. The 5-year survival rate is approximately 11%, which is one of the lowest of all types of cancer.
Most patients with pleural mesothelioma are not surgical candidates due to the aggressive nature of the cancer, so they often receive chemotherapy or immunotherapy. Patients who are surgical candidates undergo one of two surgeries for pleural mesothelioma: extrapleural pneumonectomy (EPP); or pleurectomy with decortication (P/D). EPP removes the lining of the lungs along with the affected lung. P/D leaves both lungs intact while only removing the outer lining around the affected lung.
Various mesothelioma clinical trials have examined the average survival for patients after these surgeries, and they range from 2-3 years. Most studies have found patients benefit from receiving chemotherapy either before the surgery (to shrink tumors and make removing them easier) or after the operation (to kill any small cancer cells left behind).
There are three immunotherapy drugs approved by the U.S. Food and Drug Administration for pleural mesothelioma. Opdivo and Yervoy are approved as a combination treatment when surgery is not an option for patients. Keytruda is approved for a small subset of patients whose tumor cells carry a specific genetic mutation.
Information for Patients About the Mesothelioma Study at Baylor and Duke
According to the Baylor College of Medicine website, which is affiliated with Baylor St. Luke’s, the study will consist of 23 people in each group: chemoimmunotherapy before surgery; and chemotherapy before surgery. Anyone with mesothelioma can participate but only at Baylor St. Luke’s or Duke University.
Dr. Taylor Ripley, the Director of the Mesothelioma Treatment Center at Baylor St. Luke’s, will lead the clinical trial at his cancer center. Dr. David Harpole Jr., the Vice Chief of Surgical Services at Duke University, will run the trial with Dr. Jeff Clarke at their cancer hospital.
“We will determine the disease stage and make sure (patients are) physiologically strong enough for treatment,” said Dr. Ripley, according to the Baylor College of Medicine website. “For patients who have disease that can be removed by surgery, we will randomize them to one of the two arms – either immunotherapy with two drugs, or immunotherapy with two chemotherapy agents. They will receive three cycles of each, then get reevaluated for surgery. They will then continue immunotherapy after surgery for one year.”
If you’d like to learn more about this study or how to enroll, contact Mesothelioma Guide’s registered nurse and lead patient advocate, Karen Ritter. She can answer any mesothelioma-related questions and help connect you with top cancer centers with clinical trials. Email her at karen@mesotheliomaguide.com for more information.
Sources & Author
- BCM, Duke University to study surgery treatment for mesothelioma. Baylor College of Medicine. Retrieved from: https://www.bcm.edu/news/bcm-duke-university-to-study-surgery-treatment-for-mesothelioma. Accessed: 11/15/2023.
Sources & Author
