Immunotherapy drugs are commonplace in mesothelioma clinical trials. However, in many cases, these drugs can’t fight cancer alone.

A new Phase 2 pleural mesothelioma clinical trial is giving immunotherapy some help.

Researchers from multiple cancer centers are pairing Nivolumab and Ramucirumab. Nivolumab, commonly known by the brand name Opdivo, is a PD-1 checkpoint immunotherapy treatment. Ramucirumab is an anti-VEGF drug that stops tumor growth. VEGF stands for vascular endothelial growth factor.

Dr. Arkadiusz Dudek, an oncologist at HealthPartners Institute Regions Cancer Center, is a lead investigator for the trial. He talked about the study in a press release published on the Hoosier Cancer Research Network website.

“There is a lot of interest right now in introducing immunotherapy to mesothelioma and there are several trials that are currently ongoing in the United States and other parts of the world,” Dr. Dudek said. “However, what is unique about this study that has not been done yet is to combine immunotherapy with antiangiogenic therapy.”

The study needs 35 pleural mesothelioma patients for Phase 2. Locations still recruiting patients as of Sept. 10, 2019, are:

  • Moffitt Cancer Center in Tampa, Florida
  • The University of Maryland in Baltimore
  • Karmanos Cancer Center in Detroit, Michigan
  • HealthPartners Institute Regions Cancer Care Center in Minneapolis, Minnesota

How the Clinical Trial Works

All living organisms need oxygen to live. Your body’s cells are no exception — even the cancerous ones.

Mesothelioma tumors’ need for oxygen and blood results in angiogenesis, a biological phenomenon described as the creation of new blood vessels. These new blood vessels feed the tumors, which grow and invade nearby tissue and organs.

Healthy tissue cells are then deprived of their necessary oxygen and can die. This phenomenon, called hypoxia, is part of why diseases like mesothelioma are so harmful to the body.


How Ramucirumab Fights Mesothelioma

Ramucirumab specifically targets the cancers’ growth. As an anti-VEGF drug, it blocks the creation of new blood vessels. Thus, the diseased cells cannot receive the oxygen, blood and nutrients it needs to expand.

Not only are healthy cells not infringed upon to absorb their needed oxygen levels, but the tumors are weaker and basically suffocating. So the hypoxia occurs for the mesothelioma instead of the healthy tissue.

Nivolumab then steps in for the second part of the treatment equation.


How Nivolumab Fights Mesothelioma

Mesothelioma includes the protein PD-L1, which can interact with the PD-1 protein on T-cells. These cells are the immune system’s best defense mechanism against diseases such as mesothelioma. When the PD-L1 and PD-1 proteins interact, T-cells ignore mesothelioma tumors.

Nivolumab is a PD-1 checkpoint drug often used in mesothelioma clinical trials. It blocks the interaction between the two proteins. By doing so, T-cells are on the attack against the tumors. Thanks to ramucirumab’s ability to slow or stop their growth, the tumors are weak and more easily killed by an alert and effective immune system.

The scientists running the clinical trial are looking for mesothelioma patients meeting specific qualifications. If you’re a mesothelioma patient, then you might be eligible to participate.

Our patient advocate and registered nurse, Jenna Campagna, can help you enroll in this study or find one that best fits your specific disease and circumstances. Email her at for more information on clinical trials.

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    Sources & Author

  1. Phase II Nivolumab and Ramucirumab for Patients With Previously-Treated Mesothelioma. U.S. National Library of Medicine. Retrieved from: Accessed: 09/09/19.
  2. Mesothelioma study tests combination of antiangiogenic therapy and immunotherapy. Hoosier Cancer Research Network. Retrieved from: Accessed: 09/09/19.
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About the Writer, Devin Golden

Devin Golden is the content writer for Mesothelioma Guide. He produces mesothelioma-related content on various mediums, including the Mesothelioma Guide website and social media channels. Devin's objective is to translate complex information regarding mesothelioma into informative, easily absorbable content to help patients and their loved ones.