Combining Two Immunotherapeutics for Asbestos-related Cancer

The FDA approved a combination of two immune checkpoint inhibitors to treat adult patients with unresectable malignant pleural mesothelioma.

The U.S. Food and Drug Administration (FDA) approved the combination of nivolumab (Opdivo) and ipilimumab (Yervoy) as a first-line treatment for adult patients with unresectable malignant pleural mesothelioma. This type of cancer affects the thin tissue lining the lung and is primarily caused by asbestos exposure. 

Nivolumab and ipilimumab are both immune checkpoint inhibitors. They inhibit the function of certain proteins, present on immune cells called T cells, that cancer cells use to hijack the immune system and evade detection. Blocking that process releases the brakes on T cells so they can attack and destroy the cancer cells.

The efficacy of this immunotherapy combination was investigated in a randomized, open-label trial among 605 patients who had not received any prior treatment. Patients were randomized to a group that received nivolumab plus ipilimumab for up to two years or to one that received treatment with a combination chemotherapy. Patients receiving nivolumab and ipilimumab had a median overall survival time of 18.1 months, compared to 14.1 months for patients in the chemotherapy arm of the study. 

Pleural mesothelioma is among a group of cancers referred to as malignant mesothelioma. Tumors grow in a thin layer of tissue surrounding organs in the chest, abdomen, heart, or testicles. Mesothelioma is caused by inhaling fibers from asbestos, which refers to a group of minerals that was formerly used in products including insulation and tile. According to the National Cancer Institute, there are roughly 3,000 people in the United States diagnosed with mesothelioma each year. Pleural mesothelioma accounts for roughly 80 to 90 percent of those new cases.

The FDA approval was rendered on October 2, 2020.