Chemo, Immunotherapy Combo May Be Effective Mesothelioma Treatment

BALTIMORE — Mesothelioma, a rare but very aggressive form of cancer in the lungs, is usually caused by exposure to asbestos. Once the cancer becomes inoperable, patients don’t have many treatment options. A new set of research from Johns Hopkins Medicine, however, suggests that a combination of chemotherapy and immunotherapy may be an effective first line of treatment for mesothelioma patients.

A total of 55 patients from 15 U.S. cancer treatment facilities were examined for this study. Each patient received the immunotherapy drug durvalumab in combination with cisplatin and pemetrexed (two chemotherapy drugs). Every three weeks patients were given six treatments of the combination therapy, followed by a dosage of just durvalumab alone. This went on for up to one full calendar year across all studied mesothelioma patients.

Treatment prevents ‘protective armor’ for cancer cells

Historically, mesothelioma patients treated with chemotherapy alone usually survive for an average of 12 months. Patients given the combination therapy, however, survived for an average of 20.4 months. That’s a very remarkable result; this is the first piece of research ever to show patients with inoperable mesothelioma surviving for longer than 20 months.

Moreover, none of the patients experienced any unexpected negative side effects from the combination therapy.

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After closely examining tissue samples provided by participating patients, the study’s authors discovered that the combination therapy appears to stop a certain cancerous protein (PD-L1) from forming a “protective armor” around cancer cells.

‘Promising results’ for mesothelioma patients

Inflammation is key to the development of pleural mesothelioma and, as such, it represents a key target for immunotherapy. This, in addition to earlier studies that showed promising results using the same immunotherapy drug in previously treated cases, led us to study the combination,” says Patrick Forde, an associate professor of oncology at Hopkins, in a statement. “Because of the promising results, we are in the process of starting a phase 3 study to confirm the benefit of this approach.”

This study will begin accruing patients across the United States and Australia in late 2020.

The research was presented at the the American Society of Clinical Oncology’s annual meeting.

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