Avelumab Treatment can restrict the tumor progression in mesothelioma patients who have previously received chemotherapy. This treatment is safe to use as second-line therapy for mesothelioma.

Researchers from the National Cancer Institute, National Institute of Health, Maryland have recently published the research elaborating the "Efficacy and Safety of Avelumab Treatment in Patients With Advanced Unresectable Mesothelioma."

In this study, the lead investigator, Dr. Riffat Hassan, and his colleagues have studied the effectiveness of Bavencio/ Avelumab on the mesothelioma patients who have undergone first-line chemotherapy.

The results of the study are very hopeful for mesothelioma patients who have received treatment, but the tumor is either impossible to remove surgically or start progressing again.

The clinical trials showed remarkable antitumor activity after this treatment. The researchers concluded,

"Avelumab showed durable antitumor activity and disease control with an acceptable safety profile in a heavily pretreated cohort of patients with mesothelioma."

JAMA Oncology published this study on January 3, 2019.

Importance of Second-Line of Treatment for Mesothelioma

The US FDA has approved cisplatin- pemetrexed chemotherapy as the standard-of-care treatment for mesothelioma patients. And most patients are unable to qualify for surgical treatment.

Thereby, the overall survival for patients who receive chemotherapy is just a year after the diagnosis.

The short survival time of first-line therapy is because the tumor starts progressing again and becomes unable to treat it surgically.

Unfortunately, there are no FDA approved second-line therapy available for mesothelioma.

There are specific options available in this regard, including vinorelbine, pemetrexed, and gemcitabine. But the average survival with their treatment ranges from 4 to 11 months.

Thus, clinical new clinical trials seeking better treatment options for mesothelioma can resolve this issue.

Hopeful Results of the Avelumab Treatment

In this study, the researchers studied the effect of Avelumab on 53 malignant mesothelioma patients with an average age of 67.

All of these patients had pleural or peritoneal mesothelioma, and their tumor was inoperable. And cancer progressed after two or three lines of chemotherapy.

Then the researchers observed the response of Avelumab treatment on these patients.

Avelumab is an antibody that functions against PD-1 (programmed death-ligand-1). Several tumors excessively produce PD-1 protein. The primary purpose of PD-1 is to weaken the immune system of the patient and empower tumor cells to metastasize.

The efficacy of Avelumab treatment proved very optimistic to reduce tumor progression.

  • Total disease control in 58% of the patients
  • Tumor stabilized in 49% of mesothelioma patients.
  • Patients lived without worsening of the tumor for a median of months.
  • The average overall survival of patients after this treatment was  10.7 months.
  • 17.4% of the patients were alive after one year of the therapy without tumor progression.
  • 38% of the patients experienced no tumor progression for six months.
  • 43.8% of the patients were alive after one year of the treatment.

This study elaborated on the efficiency of Avelumab treatment as the second-line therapy for patients with unresectable mesothelioma.

The researchers concluded,

"Avelumab showed clinically meaningful antitumor activity in a heavily pretreated population of patients with pleural or peritoneal mesothelioma. Although the study and its findings should be interpreted in context as a small phase 1b cohort, the level of long-term disease control, the duration of OS (overall survival), and the safety profile suggest that avelumab could be a potential new therapeutic option for patients with mesothelioma."

Future Prospects of the Study

The results of this research are promising. However, the researchers have emphasized on further research in this regard. Future research can help find more such treatments. The researchers wrote,

"Further studies of Avelumab or another anti–PD-1 or anti–PD-L1 antibodies in this disease, including combinations with other agents, are warranted."

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