Key Takeaways
- Immunotherapy is a treatment that works by restoring and strengthening the body’s own immune system to recognize and attack mesothelioma cells — rather than directly killing cancer cells the way chemotherapy does.
- Mesothelioma can only develop when the immune system is compromised. The cancer hijacks the body’s natural immunity — turning off the immune system’s ability to identify and destroy cancerous cells and disabling its antitumor defenses.
- Approved immunotherapy drugs like Keytruda and Opdivo work by blocking PD-1, a protein on T-cells that inhibits the immune response. By blocking PD-1, these drugs restore the immune system’s ability to attack mesothelioma.
- Side effects of immunotherapy are generally less severe than chemotherapy — they may include injection site reactions (rash, infection), fever, allergic reactions, and in rare cases, autoimmune issues.
- Review studies comparing immunotherapy to chemotherapy found that immunotherapy provided a slight advantage for median overall survival, while chemotherapy provided a slight advantage for progression-free survival. Results are comparable but immunotherapy has fewer side effects.
- There is currently no single standard practice for mesothelioma treatment, but immunotherapy is emerging as a potential replacement for chemotherapy as the first-line option.
Immunotherapy for Mesothelioma as Treatment Option
Immunotherapy is a relatively new form of treatment that targets, revitalizes, and calibrates the
patient’s immune system to attack mesothelioma cells. A characteristic of mesothelioma is the
cancer’s ability to hijack natural immunity–it “turns off” the immune system’s capacity to
identify and destroy antigens. It also usurps the anti tumor capacities of the immune system,
which are in place to prevent unchecked cellular growth and to prevent rogue cells from
becoming cancerous. So, mesothelioma can only develop when the immune system is
compromised or “turned off.”
Immunotherapy functions by turning on or off certain checkpoints in the immune response. For
example, Keytruda and Opdivo (approved and available treatments) work by targeting a protein
found on T-cells. T-cells are responsible for identifying, coordinating, and partaking in the
destruction of antigens and cancerous cells. The protein attached to T-cells, called PD-1, inhibits
the response of T-cells. So, Keytruda and Opdivo work to prevent PD-1 from blocking the
T-cell-mediated response, thus restoring the immune system’s capacity to destroy cancerous
cells. PD-1 blockers are only one example of the ways in which immunotherapy works to restore
functionality to different immune cells.
Potential Side Effects
Although it doesn’t have the same severity of side effects as chemotherapy, surgery, or
radiotherapy, immunotherapy is still associated with some negative responses to treatment.
Occasionally, some patients will have a reaction to the site of injection–as most
immunotherapeutic options are administered intravenously–like a rash or infection. Other times,
there could be a more systemic response, like fever or allergic reaction. In other instances,
patients may develop autoimmune issues, in which the body identifies itself as an antigen to be
destroyed. Luckily, these side effects are relatively rare and can be managed via pharmacological
intervention.
Compared to Other Treatment Methodologies
Because immunotherapy doesn’t seek to destroy or directly kill mesothelioma cells, it’s relatively
more effective than systemic treatments, like chemotherapy. However, some review studies
(2023) analyzed previous studies in order to compare the efficacy of immunotherapy versus
chemotherapy, and their findings were somewhat inconclusive. Immunotherapy provided a slight
advantage for median overall survival, while chemotherapy provided a slight advantage for
overall median progressive survival. These differentiations refer to the survival after diagnosis
and the survival without advancing symptoms, respectively.
Currently, there isn’t a standard practice for mesothelioma treatment–however, chemotherapy
has been the traditional option, given its accessibility and efficacy. Because of its results
comparable to chemotherapy and a reduced instance of side effects, immunotherapy might
become the go-to option for mesothelioma care.
If you or a loved one has been diagnosed with mesothelioma, please call 1 (800)-505-6000 or fill
out our contact form. We are here to help you navigate the legal process of filing a claim to receive
compensation for your mesothelioma diagnosis. We help mesothelioma victims and their
families in Pennsylvania.
Frequently Asked Questions
What is immunotherapy for mesothelioma?
Immunotherapy is a form of cancer treatment that works by restoring, strengthening, and calibrating the patient’s own immune system to fight mesothelioma. Unlike chemotherapy — which directly attacks all rapidly dividing cells (both cancerous and healthy) — immunotherapy targets specific mechanisms that mesothelioma uses to evade the immune system, allowing the body’s natural defenses to recognize and destroy the cancer.
How does mesothelioma evade the immune system?
Mesothelioma cells have the ability to hijack and disable the body’s natural immunity. They accomplish this in two key ways: they “turn off” the immune system’s capacity to identify and destroy foreign cells (including cancer cells), and they override the body’s built-in antitumor mechanisms that normally prevent unchecked cellular growth. This means mesothelioma can only thrive when the immune system has been compromised — which is exactly what immunotherapy aims to reverse.
What are Keytruda and Opdivo and how do they work?
Keytruda (pembrolizumab) and Opdivo (nivolumab) are FDA-approved immunotherapy drugs that belong to a class called PD-1 inhibitors. They work by targeting a protein called PD-1, which is found on the surface of T-cells (the immune cells responsible for identifying and destroying threats). PD-1 normally acts as a brake on the immune response — mesothelioma exploits this by activating PD-1 to shut down T-cell attacks. Keytruda and Opdivo block PD-1, releasing the brake and allowing T-cells to recognize and attack mesothelioma cells again.
What are the side effects of immunotherapy?
Immunotherapy side effects are generally less severe than chemotherapy. Potential side effects include:
- Injection site reactions — rash or infection at the IV site
- Systemic responses — fever, fatigue, or allergic reaction
- Autoimmune issues — in rare cases, the revitalized immune system may begin attacking the body’s own healthy tissue
These side effects are relatively rare and can typically be managed with medication. Compared to chemotherapy’s common side effects (hair loss, severe nausea, digestive problems, weakened immunity), immunotherapy is generally better tolerated.
Is immunotherapy better than chemotherapy for mesothelioma?
The comparison is nuanced. A 2023 review study found that immunotherapy provided a slight advantage for median overall survival (how long patients live after diagnosis), while chemotherapy provided a slight advantage for progression-free survival (how long patients live without their symptoms worsening). Because the efficacy is comparable but immunotherapy has significantly fewer side effects, it is increasingly seen as a viable alternative — and potentially a replacement — for chemotherapy as the standard first-line treatment.
Can immunotherapy be combined with other treatments?
Yes. Immunotherapy is frequently used in combination with other treatments. The most notable example is the CheckMate 743 trial, which combined two immunotherapy drugs — nivolumab (Opdivo) and ipilimumab (Yervoy) — and showed improved overall survival compared to chemotherapy alone. Immunotherapy can also be paired with chemotherapy (as seen in the PrE0505 and MESODEC trials), surgery, or radiation as part of a multimodal treatment plan.
What should I do if I’ve been diagnosed with mesothelioma and want to learn about immunotherapy?
If you or a loved one has been diagnosed with mesothelioma, immunotherapy may be a treatment option — either on its own or in combination with chemotherapy or other therapies. Your oncologist can help determine whether immunotherapy is appropriate based on your specific diagnosis, cell type, and overall health. For information about your legal options, call (800) 505-6000 or fill out our contact form for a free consultation.
