Mesothelioma Research, COVID Findings Featured at IASLC Conference

Research and clinical trials

Researchers from around the world presented their insights into serious lung health issues, including mesothelioma, during the 2021 World Lung Cancer Congress convened by the International Association for the Study of Lung Cancer. The conference was practically held from 8 to 14 September.

An analysis of clinical data presented at the conference found that five of seven patients with COVID-19, who were also treated for malignant mesothelioma at the Vall d’Hebron Hospital in Barcelona, ​​Spain, died during the first wave of the epidemic. Show extreme vulnerability to those with this rare cancer.

The hospital treated 38 patients with pleural mesothelioma from March 2020 to March 2021, including the seven diagnosed with COVID. Four of the five deaths were directly related to COVID.

“This study, conducted during the pre-vaccine period of the pandemic, once again shows the importance of vaccination against COVID-19,” said Dr. Susanna Cedars, a medical oncologist at Vall d’Hebron Hospital. Patients with malignant mesothelioma of the pleura are particularly susceptible to COVID-19.

Since the subsequent spread of COVID-19 vaccines, no positive cases have been attributed to pleural mesothelioma patients in the hospital, Sidras said.

The mean age of the seven patients was 62. All had epithelial tissue from mesothelioma and two were receiving oncological treatment at the time of diagnosis.

The median overall survival of the seven was 17.8 months from the time of cancer diagnosis, but less than two weeks from COVID diagnosis.

“If a patient is diagnosed with this particular disease, he or she is at increased risk of death,” Cedars said. So infection must be prevented, and we know the vaccine works.

Second-line mesothelioma treatment has potential

The Virtual World Lung Cancer Conference included other presentations on Mesothelioma, particularly in relation to therapeutic advances.

In a phase II multicenter study in Europe, severely pretreated mesothelioma patients found promising results with lurbinectedin. Both lung cancer and mesothelioma patients demonstrated clear clinical benefits from the synthetically produced antitumor agent.

The 55 mesothelioma patients in the study received lorbinectin after at least two previous unsuccessful lines of treatment. The disease control rate was a surprising 32%. The median progression-free survival was 2.8 months with an overall survival rate of 7.2 months, which is longer than typical second-line treatments with pleural mesothelioma.

There is currently no standard treatment for grade II pleural mesothelioma.

“Lorbinectin appears to be a clinically meaningful option in heavily pre-treated patients,” said Lt. Col. Daphne Dumoulin, of the Erasmus MC Cancer Institute in Rotterdam, the Netherlands.

MD Anderson report on the progress of immunotherapy

The University of Texas MD Anderson Cancer Center also gave a presentation on the safety and efficacy of the immunotherapy drug atzolizumab as part of a new adjuvant therapy and maintenance therapy for resectable pleural mesothelioma.

Thoracic surgeon Dr. Boris Sibesi, who presented the presentation, concluded that when used in combination with chemotherapy, atzolizumab enhances T-cell activation against cancer cells and prolongs postoperative survival.

Patients at MD Anderson underwent pleurectomy and excision or extrapleural pneumonectomy.

The study also met established safety standards, and showed no signs of any added adverse side effects.

“I think this is a step forward in terms of treatment,” Sebesi said.

Access to mesothelioma care is key

Dr. Estellamari Rodriguez of the University of Miami Sylvester Comprehensive Cancer Center reported on the significant difference in mesothelioma survival outcomes, the importance of access to care, income levels, and a positive association with multimodal treatment.

Rodriguez used the National Cancer Database and 2,804 cases over a 13-year period for her evaluation. It finds that patients who undergo surgery often travel a lot for treatment, and that a better understanding of the disparities in access to multidisciplinary treatment can help ensure equality of care.

“Among patients with invasive invasive malignant mesothelioma, there is significant variance in access to care with respect to distance to the elbow, type and size of the attachment,” she said. “In a multivariate analysis, receiving chemotherapy or multimodal therapy—chemotherapy and radiotherapy—predicted better outcomes, despite the patient’s race, socioeconomic status, and tumor characteristics.”

More research supports approved immunotherapy

In other news, recently updated three-year survival data reinforced the growing belief that the combination of Opdivo and Yervoy immunotherapy drugs has become an ideal first-line treatment for non-resectable pleural mesothelioma.

This week’s presentation at the European Society of Medical Oncology virtual conference includes study data showing a three-year survival rate of 23%, compared to just 15% for those receiving standard chemotherapy.

Bristol Myers Squibb, the sponsor of the International CheckMate 743 study that led to FDA approval in 2020, broke the three-year response time for the immunotherapy combination at 28%, compared to 0% for those receiving chemotherapy.

The Opdivo/Yervoy combination is now approved in 14 different regulatory regions around the world. It was the first systematic approval by the Food and Drug Administration since 2004.

“Previous results of the study have changed first-line standards of care in many countries,” said Dr. Alessandra Corione Fontekedro, University Hospital Zurich, Switzerland. “This updated data reinforces previously published findings and supports the benefit of giving patients immunotherapy rather than chemotherapy.”