Are the side effects of immunotherapy for mesothelioma good?

Immunotherapy generally does not cause the same level of discomfort as chemotherapy. This is one of the reasons why many people with cancer, including people malignant mesothelioma, prefer immunotherapy to chemotherapy as systemic treatment.

However, a new report indicates that the severity of immunotherapy side effects may be correlated with survival time.

Japanese researchers investigated whether immune system-related adverse effects (IRAEs) of the immunotherapeutic drug nivolumab lead to longer survival. Nivolumab is the generic name for Opdivo, which is approved in the United States along with another immunotherapy drug (Yervoy/ipilimumab) for unresectable pleural mesothelioma.

Link between immunotherapy side effects and survival

The study involved 11 patients, all of whom received treatment with nivolumab. It’s a type of immunotherapy for mesothelioma. The disease control rate was 91% (10 out of 11 saw their disease shrink or stagnate). The median overall survival was 15 months and progression-free survival (survival before the cancer started growing again) was 6.8 months.

What is most interesting is the severity of IRAEs which generally result in very different survival. Eight patients presented with IRAE and six had side effects of at least grade 2.

The six patients with IRAE grade 2 or higher had a progression-free survival of 13 months. The five patients with or without Grade 1 IRAE had a progression-free survival of only 3.8 months.

The median overall survival was also very different:

• More than one year for the group with IRAEs of grade 2 or more
• 8.6 months for the group with grade 1 or no IRAE

What does this mean for people with mesothelioma?

This data might not be superficially comforting for patients. Knowing that they may need to feel discomfort for the therapy to work can be discouraging. However, there is a thick silver lining to this data.

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

Before making any decision regarding treatment, we suggest you speak with a mesothelioma expert. This may be a patient advocate or a medical specialist at a cancer centre.

A patient advocate can help you find a specialist, so we suggest you start with an advocate. Email our Senior Spokesperson, Karen Ritter, at karen@mesotheliomaguide.com for answers to questions about treatment side effects and more.

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