Category: Featured News
A new worldwide clinical trial for mesothelioma is now open for enrollment
The “handshake” between the tumor and T cell prevents a T cell immune attack against mesothelioma. Disrupting the “handshake” holds the key to an immune response against this cancer. This Phase 3 immunotherapy clinical trial for mesothelioma tests a drug made to do exactly that and is now available to patients in the United States and across the world.
A new phase 3 clinical trial testing the efficacy of dual checkpoint inhibitor immunotherapy in combination with chemotherapy is now available to patients in the United States as well as around the world. The official name for the study is MEDI5752 in Combination With Carboplatin Plus Pemetrexed in Unresectable Pleural Mesothelioma and the shortened name is eVOLVE-Meso.
This AstraZeneca study tests a single immunotherapy agent called volrustomig in combination with standard chemotherapy against either standard of care chemotherapy alone or immunotherapy alone. The study builds on the recent FDA-approval of immunotherapy for mesothelioma which saw two agents, nivolumab (Opdivo) and ipilimumab (Yervoy), activate the immune system against cancer cells by binding to two receptors located on the T cell: the PD-1 and the CTLA-4. Single agent volrustomig targets the same two proteins, but the study also adds standard chemotherapy to its protocol.
How to inquire about enrollment?
The clinical trial is widely available at centers across the United States. A patient should contact their treating physician to discuss enrollment. Locations where the Evolve-Meso clinical trial is available are listed here: https://clinicaltrials.gov/study/NCT06097728#contacts-and-locations.
How does immunotherapy work to kill mesothelioma cells?
To understand how immunotherapy treatment works, we must first understand why the immune system tends to stay inactive against mesothelioma cells. Both the T cell and other cells, including tumors, express proteins. When certain proteins on the T cell bind to their counterparts on a healthy cell, this communicates to the T cell to not attack the healthy cell. This is an important preservation mechanism that prevents autoimmune reactions. So when the tumor’s proteins bind to the ones on the T cell, they tell the immune system not to attack which allows the cancer to proliferate. Immunotherapy medications act as a decoy binding protein that binds to either the T cell or the tumor cell, disrupting their ability to bind with one another.
In the top part of this image, the T cell and the tumor cell connect causing no immune response against the tumor. In the bottom part of the image, the immunotherapy drugs connect to the expressed proteins on either the T cell or tumor thus inhibiting the connection between the two which in turn creates an immune reaction against the tumor. This is the basis of checkpoint inhibitor immunotherapy.
Immunotherapy + Chemotherapy: what is the rationale?
A common and valid question about combining chemotherapy with immunotherapy is: are we just throwing the kitchen sink at mesothelioma to see what sticks?
The answer is no.
There are, in fact, scientific reasons that would suggest that combining these two methods would lead to better results than administering them one at a time. Reason number one can be found in the answer to the question “why does the immune system not recognize mesothelioma as a foreign entity worth attacking from the beginning?” The answer is that mesothelioma cells’ receptors mimic those on the surface of healthy cells and they use the brakes built into the immune system to their advantage. But when chemotherapy is used to kill the cancer, the by-product of those dead cancer cells is seen as a foreign body by the immune system. So, adding chemotherapy to an immunotherapy regimen is one way to maximize the anti-tumor activity of both agents.
Timeline of FDA-approvals for mesothelioma
2004: Chemotherapy (Alimta/cisplatin)
2022: Immunotherapy (nivolumab / ipilimumab)
2024: Immunotherapy + chemotherapy for advanced mesothelioma (pembrolizumab also known by the brand name Keytruda, which is an anti-PD-1 agent, plus standard chemotherapy)
What is the difference between volrustomig and other immunotherapy agents used against mesothelioma
The volrustomig study is different from the 2024 immunotherapy (Keytruda) plus chemotherapy combination approval because volrustomig singularly binds to both the PD-1 and CTLA-4 receptors. Immunotherapy drugs targeting only the PD-1 or PDL1 receptors have shown to not be as effective as those also targeting the CTLA-4 receptor.
These two proteins, also known as checkpoint inhibitors, are located on the T cell. There, they play a crucial role in signaling to the immune system whether to attack the cancer cells or not. Without immunotherapy treatment, the tumor receptors (PD-L1 and CD80) bind to the reciprocal T cell receptors, signaling to the immune system not to attack the tumor. With immunotherapy that binds to them instead, the “handshake” between the tumor and the T cell is disrupted letting the immune system to attack the tumor.
Why should a patient consider participation in this study?
Mesothelioma patients have limited options for treatment available to them while the cancer is aggressive and moves fast. This study is an opportunity to try the combination of chemotherapy plus immunotherapy to potentially reap the most benefits.
What are the risks?
As with any study and/or treatment, one risk is that the treatment won’t work. With mesothelioma, this is a significant risk because the disease is quick and aggressive. However, over time, survival for mesothelioma patients has increased at least in part due to advancements in treatment options, and this study is one such option. Being a Phase 3 clinical trial, the drugs it uses have already been extensively studied for safety, but it is important to note that undergoing any type of immunotherapy can cause unintended immune reactions some of which can be life threatening. Speaking with the treating physician about potential risks and benefits is an important part of enrolling into a clinical trial.
What other treatments are in the works for mesothelioma?
Two other significant studies have been released in the last two years, both holding promise with regards to further treatment approvals. Both studies showed an improvement in survival in the most aggressive type of mesothelioma called the sarcomatoid subtype.
One of these studies combined Alimta/cisplatin (chemotherapy) with atezolizumab (immunotherapy) and also with bevacizumab (a VEGF inhibitor agent that limits vascular development leading to the tumor).
The other study, called ATOMIC, was successful in improving survival in the sarcomatoid and biphasic mesothelioma subtypes (most aggressive) by depriving the cancer cells of arginine, which is generally widely present in the most aggressive mesotheliomas.
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New episode of Meet the Mesothelioma Experts About Financial Compensation for Mesothelioma
Last week, the Mesothelioma Applied Research Foundation released a new episode of its Meet the Mesothelioma Experts: Legal Edition series discussing financial compensation issues for mesothelioma patients. Featured guest of the program was Joseph Belluck, partner with the Belluck & Fox firm, who was interviewed by the organization’s board of directors’ member, Cheryl Bruner. Mr. Belluck answered a number of questions of interest to those who have just had a mesothelioma diagnosis and their families.
Acting with Urgency
One of the take-home messages is that while a mesothelioma diagnosis requires medical urgency and treatment, so does the legal process. This is due to a number of issues, the statute of limitations being one, but not the only one. As Mr. Belluck states in this program, it is important to file a lawsuit as soon as realistically possible in order to get a place in line, even if later adjustments are necessary. An experienced law firm will know enough information about a case very quickly and will be able to proceed with expedience.
“Usually, right after contact, we file the case, we start working on the bankruptcy trust claims and also starting to work on the lawsuit, which we do in tandem. Typically, the first settlements will come in about 45 – 60 days and the whole case will be completed within 12 months,” said Mr. Belluck in the program.
Mr. Belluck adds that whether a patient chooses to hire his firm or another firm, he still encourages them to make sure to do so quickly for the reasons outlined above.
Watch the video:
00:00 Introduction
1:11 Why Belluck & Fox chooses to sponsor the Meso Foundation and how their mission resonates
6:15 How Belluck & Fox works within the meso community
7:47 Next steps in the legal process after diagnosis
11:05 Litigation timeline after choosing a law firm
14:01 How much time and effort is anticipated to dedicate to litigation
16:14 Options for taking legal action
21:58 Timeline of settlement funds
28:05 How much of a settlement does a patient/family receive
35:37 Advice for future clients in deciding legal action
Compensation Programs for Mesothelioma Patients and their Families
There are several main compensation programs that are typically available to mesothelioma patients. They include simple programs like health insurance, private disability insurance, social security disability benefits, and workers compensation if the person is still employed. Additionally, veterans’ benefits are available for people who served in the military and have a service connection to asbestos exposure. Mesothelioma bankruptcy trusts are another avenue to pursue for compensation. There are about 40-50 individual funds that have been set up by companies that made asbestos products and went into bankruptcy. As part of their bankruptcy reorganization, they set up a fund for their product. And the last option available is to file a lawsuit individually, not a class action, against the companies that made asbestos products that the patient was exposed to.
Mr. Belluck and his law firm offer free consultations by submitting a quick form on the firm’s website at www.belluckfox.com.
New Immunotherapy Drugs Show Promising Results for Certain Cancers in Clinical Trials. Is Mesothelioma Next?
Participation in Clinical Trials is how progress is made in medical research. The trials are regulated and must conform to rigorous standards and be able to be replicated. Research scientists dedicate their careers to making progress with treatments for diseases using Clinical Trials. The inclusion and exclusion criteria are very specific. Some Clinical Trials are not able to be done due to lack of enrollment. Participation is voluntary and only with informed consent that the patient can withdraw at any time. In the United States it is estimated that only 5% of adults eligible to participate in a Clinical Trial sign on.
Progress can be slow and results are often not what the researchers had hoped for. Responses can vary by individual participants and success is often made in small percentages of people responding to the treatment.
This past week some very exciting news was published in the New England Journal of Medicine and reported widely in the media. A surprising report was published of the results of a Clinical Trial with a small sample of patients diagnosed with a specific mismatch-repair deficiency rectal cancer and the immunotherapy drug Dostarlimab, brand name Jemperfi. This specific type of rectal cancer makes up 5-10% of all rectal cancers.
Before beginning the standard treatment for this type of rectal cancer, which is chemotherapy followed by radiation followed by surgery, these patients joined a Clinical Trial testing Dostarlimab infusions before the standard treatment. Dostarlimab is classified as an immunotherapy drug. It has been approved by the FDA for treatment of certain types of endometrial cancers. The results were a surprising 14 out of 14 patients having a full remission. No evidence of their disease was found! For 100% of the patients enrolled in the study to have no evidence of disease after six months of treatment is what researchers dream of. The importance of this response is exciting for all of the patients and researchers and for possible results with other cancers. More research with a larger number of patients will need to be done.
These results are encouraging for research for malignant mesothelioma that are ongoing with some Clinical Trials including immunotherapy drugs.
With renewed enthusiasm we encourage those diagnosed with Malignant Mesothelioma or any other cancer to checkout www.ClinicalTrial.gov or ask your treatment team about eligibility to participate in a Clinical Trial.
For Patients, Nutrition and Exercise Plays an Important Part in the Mesothelioma Journey
Nutrition and exercise plays an important part in a person’s journey with Malignant Mesothelioma. Recovering from Mesothelioma treatment can be difficult. Whether it is recovering from chemotherapy, radiation, or surgery it can be challenging regardless of the type of treatment you have experienced.
Nutrition can play a key role in recovering from your treatment. Choosing foods that are high in protein and fat will offer the most reward. Offering starchy foods or carbohydrates like pasta, bread, potatoes and sources of protein like fish, chicken, meats, nuts, turkey, and cheese are great options. For many, these food choices can be overwhelming and difficult to eat. Breaking down meals to smaller portion sizes and more frequently may be easier. If food is not the best choice, drink high calorie protein drinks. There are many protein drinks available to suit your needs and taste. We have cared for many people who have undergone surgery or chemotherapy and food is the last thing they can enjoy.
We encourage patients to weigh themselves weekly to monitor progress. Eating when recovering can be a huge chore for some and can become a daunting task. If possible, try to eat one more thing than you did the day before.
For many their taste buds have been altered. Many times, we hear that food has a metallic taste when receiving chemotherapy. Just keep trying foods and taking in calories. Along the road to recovery things change. If you are recovering from surgery or chemotherapy the taste buds will change again. Maybe the food that tasted awful a few weeks ago will taste better down the road.
Many medical centers where one receives their care can provide nutritional support with nutritionists. Adequate nutrition to maintain energy, muscle mass and your weight may help with tolerating your treatment better. The American Cancer Society states, proper nutrition during treatment supports your immune system and may lower your risk of infection and help you heal and recover faster.”
Many people attempt to continue with their exercise regime throughout treatment, and others never had a regime and become engaged in one. Walking is one of the easiest and accessible forms of exercise. Whatever your choice of exercise is there are many benefits to it while recovering from your treatment with cancer. Exercise can lower your risk of depression, anxiety, improve sleep and reduce the risk of developing other chronic diseases. Many people include stretching and breathing exercises as well.
Healthier lifestyles can result in improvement of quality and length of life for some cancer survivors, according to the National Cancer Institute. Surround yourself with people who will maintain positivity and cheer you on. The benefits of developing a healthier diet and exercise habits during treatment may carry over into survivorship. According to the National Cancer Institute, research suggests that these healthier behaviors may improve the quality and length of life of some cancer survivors. If you have questions, reach out to your treatment center and see what support is available to you. There are many support systems to help with nutrition. Patients who have journeyed before you with the same issues are often willing to share what worked for them, when recovering from and living with Mesothelioma.
Expressing Gratitude as a Mesothelioma Patient
This time of year is ideally filled with family and friends getting together and creating memories.
For people that are facing health challenges like being diagnosed with malignant mesothelioma, the holidays can be a challenging time. When your world has been upended and you may not be at home for your usual festivities or you are not feeling the holiday mood, feeling grateful can be hard to do. Expressing gratitude may be even harder. Sometimes it is necessary to dig down deep within yourself to express thankfulness to those that are helping you.
During this time of year there is a lot of effort spent on getting the perfect present, the most thoughtful, the one thing that the person can really use for family and friends. For many of us this adds stress to what can already be a stressful time. Presents don’t have to be shiny and new and perfect, the gift of interacting and strengthening a bond in a relationship can be a much more meaningful present.
We all need to take some time out of this busy holiday season to express our gratitude to people that impact our lives. Many of us spend time and money shopping, decorating, baking – when for many a much more impactful thing would be to stop and thank someone for their kindness.
Telling someone that you are grateful for their support and presence in your journey can benefit both you and them. Acknowledge someone for listening to you when it would have been easier for them not to take the time.
By making a call, sending a note, text, or e-mail, or even giving a shout out on social media, you have acknowledged the kindness that has been shown. Recognition and acknowledgment can help improve and strengthen your relationships,
Research has shown that one of the benefits for the person expressing gratitude is greater happiness. Gratitude helps people relish good experiences, improve their health and improve their relationships.
This holiday season, slow down and acknowledge those that enrich our lives in a way that can’t be quantified, and so much more than a perfect present.
Happy Holidays!
Free Mesothelioma Patient & Treatment Guide
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It contains a wealth of information and resources to help you better understand the condition, choose (and afford) appropriate treatment, and exercise your legal right to compensation.
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