Immunotherapy is already approved by the U.S. Food and Drug Administration (FDA) as a first-line treatment for unresectable pleural mesothelioma. It’s also a promising option before and after surgery for this rare cancer.
Immunotherapy is not yet approved formally for the other main type of mesothelioma, peritoneal mesothelioma, but clinical trials and studies also indicate it can benefit patients.
In a recent study, a patient with peritoneal mesothelioma who received the immunotherapy drug Opdivo prior to cytoreduction and HIPEC surgery had a significant boost in their survival.
The study’s author, Dr. Paul Sugarbaker, is a retired peritoneal mesothelioma specialist. He has performed an impressive number of cytoreduction and HIPEC surgeries for this rare cancer, which forms in the lining of the abdominal cavity. He advocates for using immunotherapy before surgery to reduce the size of tumors and increase the chances of complete removal of cancer.
Case Study of Using Immunotherapy Before Peritoneal Mesothelioma Surgery
The medical paper, which was published in the International Journal of Surgery Case Reports, focuses on one patient: a 39-year-old woman diagnosed with peritoneal mesothelioma. She was originally diagnosed with ovarian cancer – a common misdiagnosis for peritoneal mesothelioma – and later correctly diagnosed with the sarcomatoid cell type.
She received the immunotherapy drug Opdivo, the brand name for nivolumab. Opdivo is an immune checkpoint inhibitor. This type of immunotherapy blocks certain proteins from interacting and helps the immune system’s T cells track down and destroy cancer cells.
According to Dr. Sugarbaker’s report, Opdivo was beneficial as a precursor to cytoreduction and HIPEC surgery. HIPEC is a heated chemotherapy where the patient receives the treatment directly into their abdominal cavity. Cytoreduction involves the removal of all visible diseased tissue from the abdominal cavity.
The patient received this surgery along with NIPEC (normothermic long-term intraperitoneal chemotherapy), which involves delivering chemotherapy directly into the abdominal cavity a few weeks after surgery. This strategy addresses any lingering cancer cells still in the cavity.
The combination of these therapies worked. The patient is five years disease-free since the treatment.
Options for Patients Interested in Immunotherapy
Immunotherapy for mesothelioma is growing in use among patients and support among doctors. Pleural mesothelioma patients can access Opdivo and Yervoy as a combination approved by the FDA for unresectable cases. Peritoneal mesothelioma patients can enroll in a clinical trial featuring immunotherapy.
There are even trials combining immunotherapy with surgery for both types of mesothelioma, and the early results are promising.
If you’d like to learn more about immunotherapy for mesothelioma and any clinical trials for peritoneal mesothelioma or pleural mesothelioma, contact our team. Karen Ritter, our registered nurse, can help you find a cancer center hosting a mesothelioma clinical trial. Email karen@mesotheliomaguide.com for help.
Sources & Author
- Response to Nivolumab followed by complete cytoreductive surgery with HIPEC resulted in long-term survival in a patient with sarcomatoid-predominant biphasic peritoneal mesothelioma. A case report. International Journal of Surgery Case Reports. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/37267791/. Accessed: 06/06/2023.
Sources & Author
