Opdivo, Yervoy Treatments May Slow Mesothelioma Progression: Study

The findings of a new study suggest that the cancer drugs Opdivo and Yervoy may be effective in battling mesothelioma, a rare and usually fatal type of lung cancer, which may develop decades after asbestos exposure. 

Bristol-Myers Squibb and the French Cooperative Thoracic Intergroup issued a press release last week, claiming that a combination of Opdivo and Yervoy slowed the progression of mesothelioma for nearly six months in patients with relapsed malignant pleural mesothelioma. The findings were presented at the annual meeting of the American Society of Clinical Oncology.

The same study looked at the use of Opdivo alone, which was less effective, but still stopped mesothelioma progression for a median of four months.

Despite the findings, there are concerns about taking the drugs in combination. In November, researchers from Vanderbilt University published a study indicating that cancer drugs known as immune checkpoint inhibitors (ICIs), may be linked to an increased risk of a form of heart damage known as fulminant myocarditis.

The warning came following the deaths of two Opdivo and Yervoy patients.

Opdivo (nivolumab) and Yervoy (ipilimumab) are two members of this class, which are each manufactured and sold by Bristol-Myers Squibb, for treatment of melanoma skin cancer. The patients described in the study were taking the drugs in combination, leading researchers to call for doctors to begin heart testing patients taking any combination of immune checkpoint inhibitors.

Those findings came several months after a study by Johns Hopkins researchers linked Opdivo and Yervoy to immune-related adverse events, which could manifest as inflammatory arthritis and sicca syndrome.

Other types of immune responses have been linked to the drugs, which strengthens the chances that the drugs can cause arthritis as well.

During the original clinical trials for Yervoy and Opdivo, increased risks were detected for inflammatory bowel diseases, lung inflammation, and other side effects that are considered immune-related. However, given the fatality of mesothelioma and the short survival rate after it is diagnosed, those risks, if confirmed, may be less of a factor for mesothelioma patients.

Mesothelioma Cancer

The only known cause of mesothelioma cancer is exposure to asbestos fibers, which were used in a variety of manufacturing and building industries until most uses were banned more than 30 years ago.

The condition has proven to be fatal in nearly all cases, as it is often not diagnosed until the cancer is already at a very advanced stage, resulting in a very short life-expectancy after diagnosis.

In March, the U.S. Centers for Disease Control and Prevention (CDC) reported that malignant mesothelioma has been linked to more than 45,000 deaths in the U.S. from 1999 to 2015, and rates are continuing to rise, even though most uses have long been banned.

Mesotheslioma lawsuits are part of the largest mass-tort in U.S. history, with more than 600,000 people having filed a case against more than 6,000 defendants due to injuries caused by inhaling asbestos fibers. In addition to individuals directly exposed to asbestos, a growing number of the lawsuits filed in recent years have involved second-hand exposure among individuals who inhaled fibers carried on on the clothes or in the hair of their parents when they were children.

Prior projections by the CDC suggested that the number of asbestos deaths from malignant mesothelioma would peak years ago. However, that does not appear to be the case.

Instead, from 1999 to 2015, the annual mesothelioma death rate increased by 4.8%, from 2,479 deaths in 1999 to 2,579 deaths in 2015.