Recently, there has been rising hope that immunotherapy agents (known as checkpoint inhibitors) can provide an effective treatment for mesothelioma. It has been widely reported that these treatments have successfully prolonged some patients’ lifespans.

However, the lead investigator for the National Cancer Institute, Dr Hassan, has raised some concerns that the benefits of immunotherapy are not reaching enough mesothelioma patients.

The concern

Dr Hassan was the lead scientist in a study considering the immunotherapy, Avelumab. The results of this clinical trial showed that, on average, there was a 1 year absence of progressive disease in 20% of cases. Whilst pleased for the 20% of patients reporting positive results, Dr Hassan considers that there is still more work to be done to benefit more patients. He suggests that he would like to see a 60 to 80% response rate, which requires more research to achieve.

Research can help scientists find out why immunotherapy works so well for some patients, and how the effectiveness of immunotherapy can be improved.


Immunotherapy is normally used as a second-line treatment for mesothelioma. Chemotherapy, radiotherapy or surgery are usually the first treatments that patients receive. After these treatments have been considered or tried, a patient may then be treated with immunotherapy.

Immunotherapy drugs attempt to neutralise certain cell proteins in cancer cells which allow cancer cells to hide from the body’s own immune system. The immunotherapy drugs, therefore, allow the body to attack the cancer cells.

Currently, standard immunotherapy treatment given to mesothelioma patients uses Pemetrexed and not Avelumab. Avelumab specifically targets a protein cell, PD-L1 in the tumour. Of the patients studied with high levels of this protein, they had a median survival rate of just over 20 months.  It was also reported that 24 of the 48 patients experienced some reduction in the mesothelioma tumour.  Also encouragingly, only eight patients experienced serious side-effects.

Clearly more research is needed. With a further 50 trials planned worldwide, it is hoped that immunotherapy treatments could provide a real therapeutic treatment option for mesothelioma cancer victims.

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