Immunotherapy doesn’t typically cause the same level of discomfort as chemotherapy does. This is one reason why many people with cancer, including people with malignant mesothelioma, prefer immunotherapy to chemotherapy as a systemic treatment.

However, a new report indicates the severity of side effects with immunotherapy may correlate to length of survival.

Researchers in Japan investigated whether immune-related adverse effects (IRAEs) from the immunotherapy drug nivolumab led to longer survival. Nivolumab is the generic name for Opdivo, which is approved in the United States with another immunotherapy drug (Yervoy/ipilimumab) for unresectable pleural mesothelioma.


Link Between Side Effects of Immunotherapy and Survival

The study looked at 11 patients, who all received nivolumab therapy. This is a type of immunotherapy for mesothelioma. The disease control rate was 91% (10 of 11 had their disease shrink or stall). The median overall survival was 15 months and progression-free survival (survival before cancer begins growing again) was 6.8 months.

What’s most interesting is the severity of IRAEs led to a much different survival usually. Eight patients experienced IRAEs, and six had side effects of at least grade 2.

The six patients with grade 2 or higher IRAEs had a progression-free survival of 13 months. The five patients with grade 1 IRAEs or no IRAEs had a progression-free survival of just 3.8 months.

The median overall survival was much different, too:

  • Higher than one year for the group with grade 2 or higher IRAEs
  • 8.6 months for the group with grade 1 or no IRAEs


What Does This Mean for People With Mesothelioma?

This data might not be comforting on the surface for patients. Knowing they may need to experience discomfort for the therapy to work can be discouraging. However, there’s a thick silver lining to this data.

For starters, discomfort can be managed with medication. Palliative care can help reduce discomfort experienced from immunotherapy. Early detection is also important, as it can improve disease control.

Before making any decisions regarding treatment, we suggest talking with a mesothelioma expert. This might be a patient advocate or a specialist doctor at a cancer center.

A patient advocate can help you find a specialist, so we suggest starting with an advocate. Email our lead advocate, Karen Ritter, at to get answers to questions about treatment side effects and more.

    Sources & Author

    • Correlation between immune-related adverse events and therapeutic effects of nivolumab in patients with malignant pleural mesothelioma. BMC Pulmonary Medicine. Retrieved from: Accessed: 11/22/2021.
Devin Goldan image

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.

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