At the annual meeting (held virtually from 29 May to 31 May 2020) of the ASCO (American Society of Clinical Oncology), a researcher from the Johns Hopkins Kimmel Cancer Center revealed that a combination of chemotherapy/immunotherapy can be utilized for first-line treatment of malignant pleural mesothelioma.
Inoperable malignant pleural mesothelioma, a rare and aggressive cancer, is often caused by exposure to asbestos. It damages the protective pleural membrane of the lungs. Inflammation, a key to the development of pleural mesothelioma, is a pivotal target for immunotherapy. A multicentre study was therefore conducted to explore the efficacy of a combination of chemotherapy/immunotherapy in patients with advanced pleural mesothelioma.
From 15 US (United States) cancer centers, a total of 55 cancer patients were recruited in this study. To develop a new first-line treatment, the participants were administered the immunotherapy drug (durvalumab) in combination with two anticancer chemotherapies (cisplatin and pemetrexed). Every three weeks, six treatments of the combination therapy were given. For up to one year, this was followed by treatment with durvalumab alone.
The combination of chemo-immunotherapy enhanced overall survival to 20.4 months in comparison with the historically expected survival of 12 months with chemotherapy alone. For patients with inoperable mesothelioma, this is the first study to show survival times exceeding 20 months. Overall, the patients tolerated the therapy well. No unexpected adverse effects were witnessed.
The tissue samples from patients treated with combination therapy depicted that the chemo-immunotherapy combination prevented a protein called PD-L1 from forming a protective armor around tumor cells. The checkpoint blockers, such as durvalumab, act against PD-L1 protein. They disrupt the ability of cancer cells to avoid detection and destruction by immune cells.
Thus, the chemo-immunotherapy combo is valuable for first-line management of advanced mesothelioma. Due to the promising results, a phase 3 clinical trial will be soon initiated to validate the benefit of this approach. This study will begin enrolling across Australia and the US in late 2020.
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Source: Science Daily
Original title of the article Chemotherapy/immunotherapy combo shows promise for first-line treatment of mesothelioma