Over the last 5 years, researchers made many advances in mesothelioma therapy. Patients have more standard treatment options than ever before. One of those options even works well against tumors formerly considered difficult to treat.
Before 2018, the standard treatment for inoperable pleural mesothelioma was chemotherapy. This came with a life expectancy of about 1 year. Immunotherapy had not yet earned approval as a systemic treatment. And researchers were just beginning to release initial data about Tumor Treating Fields. Things have truly changed for the better in the last 5 years.
Tumor Treating Fields: From Trials to Humanitarian Device Approval
In 2018, a clinical trial shared the results of a novel cancer treatment called Tumor Treating Fields (TTFields). This therapy uses gentle electric fields to disrupt cancer cell growth.
The study involved 80 patients with inoperable pleural mesothelioma. Their treatment included TTFields and standard chemotherapy. The median overall survival for these patients was 18.2 months. That’s about 6 months longer than the prognosis with chemo alone.
The device earned approval through a humanitarian exemption track in 2019. This means trial data only had to demonstrate TTFields as safe and likely beneficial. The humanitarian exemption has a lower standard than the usual medical device approval pathway.
The TTFields device is intended for use within a multimodal treatment plan alongside standard chemo. Patients now have access to this unique cancer-fighting device.
Immunotherapy: From Nothing to Standard Treatment Option
Back in 2018, immunotherapy was not available for mesothelioma patients outside of clinical trials. Not only has that changed in recent years, but immunotherapy drugs are now a standard option for pleural and peritoneal mesothelioma.
Checkpoint Inhibitors Earned Approval for Mesothelioma
Both 2020 and 2021 saw exciting developments in the area of immunotherapy. One of the most important advances involved U.S. Food and Drug Administration (FDA) approval. The FDA approved a combination of immunotherapy drugs to treat pleural mesothelioma.
The approval trial compared survival rates of patients treated with Opdivo® (nivolumab) and Yervoy® (ipilimumab) or chemo. Those who received Opdivo+Yervoy had significantly better survival rates.
Data Showed Opdivo+Yervoy Do More Than Extend Survival
In the clinical trial, Opdivo+Yervoy treatment came with several benefits. Patients reported lessening symptoms and improved quality of life. The drug combination also extended survival better than chemo.
Opdivo+Yervoy Worked Well Against Difficult-to-Treat Cell Types
Most mesothelioma patients have tumors consisting of epithelial cells.Historically, this cell type has had the best prognosis. Sarcomatoid and biphasic cell types are less common and do not respond well to most treatments.
The Opdivo+Yervoy combination was the first therapy to work well against these cell types. For patients with sarcomatoid or biphasic tumors, the combo more than doubled survival.
Opdivo+Yervoy Changed Surgery Eligibility
In 2022, researchers reported another potential benefit of this drug pair. Doctors treated a pleural mesothelioma patient with Opdivo+Yervoy. Before treatment, the case was considered inoperable. However, the drug combo shrunk the tumors substantially, making the patient eligible for surgery.
Specialty Care Matters for Mesothelioma
In 2022, new data emerged showing the importance of specialized mesothelioma care. Researchers compared mesothelioma patients treated by providers with different levels of mesothelioma expertise. They found mesothelioma-specific care had several benefits, including:
- Better access to surgery: Patients who received specialty care were more than 3 times as likely to undergo surgery.
- Boosted treatment use: A higher percentage of specialty care patients underwent any form of treatment.
- Improved survival: Patients treated by specialists survived about 6 months longer than those who were not.
This study highlighted the importance of working with experienced doctors. Patients looking for the best treatments should work with cancer centers that specialize in mesothelioma. This may provide access to more effective therapies and a better chance of long-term survival.
2024 and Beyond
Mesothelioma research advancements since 2018 have improved prognoses and quality of life for many patients, and the work continues. Researchers continue to study new treatments and diagnostic tools. A number of ongoing clinical trials will continue into 2024 and beyond. This ongoing work offers hope for even better treatments in the future.
