Chemoimmunotherapy may kill cancer cells more quickly while decreasing the negative effects of chemotherapy. This could result in increased survival rates for mesothelioma patients, who often struggle to live past one or two years following their diagnosis. Chemoimmunotherapy drugs may be the “next frontier” in treating mesothelioma.

What Is Chemoimmunotherapy?

Chemoimmunotherapy is a promising treatment option for certain types of cancer that combines chemotherapy and immunotherapy.

Chemotherapy is the use of drugs to kill cancerous cells or slow their growth. Immunotherapy is the use of various methods to stimulate the body’s ability to restore the immune system.

Called the “next frontier” of mesothelioma treatment by researchers, chemoimmunotherapy is a combination of several different drugs given intravenously every 3 weeks for a maximum of 12 months.

Though chemoimmunotherapy is only currently available to qualifying mesothelioma patients through clinical trials, the results have been promising. If the drug therapy advances through the next phase of clinical trials, it could then be made available to the public.

Researchers are optimistic that chemoimmunotherapy will offer better results to mesothelioma patients than chemotherapy or immunotherapy alone.

How Do Chemotherapy and Immunotherapy Work?

Chemotherapy and immunotherapy were once considered incompatible to be used together. This meant that patients would have to choose between one over the other, as each treatment option has its own set of limitations.

Chemotherapy for Mesothelioma Patients

Chemotherapy is one of the most common treatments for mesothelioma. It can be used in combination with radiation therapy or surgery and can also be given to patients who are not candidates for surgery.

A drug called Alimta (pemetrexed) used in combination with platinum-based antineoplastic drugs is the standard chemotherapy treatment given to patients with pleural mesothelioma.

The main benefit of chemotherapy is that it has been shown to kill cancer cells that create tumors. It can also shrink tumors in some patients and limit new tumors from growing.

Chemotherapy does, however, come with some disadvantages since the drugs can also impact normal cells.

Chemotherapy may cause the following side effects:

  • Changes in weight and appetite
  • Fatigue
  • Hair loss
  • Lowered immunity
  • Nausea
  • Vomiting

Immunotherapy for Mesothelioma Patients

Immunotherapy is the use of different methods to stimulate the body’s ability to restore the immune system to fight cancer on its own.

It is a type of biological therapy, which means that it is made from living organisms.

An immunotherapy drug called durvalumab is an Anti-PD-L1 monoclonal antibody, which is a “targeted” cancer therapy. This means that it can target only specific cells and cause less toxicity to healthy cells.

Immunotherapy can be administered in several different ways: 

  • Intravenous
  • Intravesical (directly into the bladder)
  • Oral
  • Topical

The main benefit of immunotherapy is that it helps the immune system to better defend itself against cancer. As with chemotherapy, immunotherapy also comes with the risk of side effects.

Side effects of immunotherapy include:

  • Flu-like symptoms
  • Organ inflammation
  • Pain, swelling, or itchiness of the skin
  • Swelling and weight gain

Why Chemoimmunotherapy Is Such a Promising Treatment

Treating patients with immunotherapy in combination with chemotherapy means there are two cancer-cell attackers: the body’s immune system and the chemotherapy drugs.

Therefore, the tumors could shrink faster compared to using only one of the methods.

A phase 2 chemoimmunotherapy clinical trial called “DREAM” studied 54 participants from December 2016 to September 2017. The study’s outcomes were promising enough to advance the trial to phase 3.

The results of the clinical trial included:

  • Participants showed higher rates of progression-free survival at six months than anticipated.
  • Fewer than half of the patients had immune-related issues with the treatment.

There is still more research to be done, but researchers have concluded that the DREAM study of chemoimmunotherapy demonstrated the results and safety required to evaluate further.

There is hope that using immunotherapy to boost the immune system’s response, while also using chemotherapy to kill existing mesothelioma cancer cells, will have the most potential for extending patients’ lives.

Many Chemoimmunotherapy Clinical Trials Are Available Now

Currently, the only way to know if chemoimmunotherapy will be beneficial is by participating in a clinical trial. Mesothelioma patients can find a clinical trial that fits their needs on clinicaltrials.gov.

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Sources
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  2. Journal of Thoracic Oncology. (October 2018). “OA08.02 DREAM - A Phase 2 Trial of Durvalumab with First Line Chemotherapy in Mesothelioma: Final Result.” Retrieved from https://www.jto.org/article/S1556-0864(18)31234-6/fulltext. Accessed on November 21, 2019.
  3. NCBI. “Chemoimmunotherapy.” Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2919833/. Accessed on November 21, 2019.
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    Accessed on November 21, 2019.
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    Accessed on November 21, 2019.

Last modified: December 4, 2019