Intro
Dr. Patrick Forde, MD, is leading the charge in a new clinical trial investigating the effectiveness of immunotherapy in patients who are surgical candidates. Buerkley Rose, RN, MSN, of the University of Chicago Medicine moderated a conversation between Dr. Forde (Johns Hopkins) and his colleagues Richard Battafarano, MD (Johns Hopkins) and Joseph Friedberg, MD (University of Maryland).
The Clinical Trial
This clinical trial builds on the work that has been done in other tumor types. In this case, researchers are looking at the benefits of treating mesothelioma patients with immunotherapy prior to surgery. The trial came about through conversations between investigators at Johns Hopkins, University of Maryland, MD Anderson and others. Dr. Battafarano and Dr. Forde have collaborated for many years in lung cancer research and treatment. During this time, they both have seen effectiveness of immunotherapy for advanced mesothelioma and in non-surgical candidates.
“We thought it would make sense to move immunotherapy forward in the treatment paradigm and perhaps treat it at the earliest stage possible before a patient undergoes surgery,” Forde said.
At the moment, the trial involves enrolling a cohort of patients who will receive the anti PD-1 antibody nivolumab for a period of six weeks prior to surgery. Then, patients will proceed to surgery with Dr. Battafarano or Dr. Joseph Friedberg at one of three medical sites. That surgery could be either an extrapleural pneumonectomy (EPP), a surgery for malignant pleural mesothelioma that involves the removal of a lung, a portion of the diaphragm, and the linings of the lungs and heart. Or it could be a pleurectomy/decortication, which involves removal of the pleural lung lining and all visible tumor masses, while leaving the affected lung in place. Patient and surgeon will decide together on which surgery is best suited for that patient. Another discussion will take place after surgery, this one about chemotherapy and potential radiation therapy, depending on the situation. After chemotherapy and possible radiation, the patient will restart immunotherapy for one year of treatment.
“That sounds intensive but what I normally recommend to patients is to take it step by step,” Forde said.
Our sponsors
MesoTV is a program by the Mesothelioma Applied Research Foundation. This program is made possible by our generous sponsors: Maune Raichle Hartley French & Mudd, LLC (MRHFM); Belluck & Fox; Bristol Myers Squibb; Novocure; Merck; The Gori Law Firm; Early Lucarelli Sweeney & Meisenkothen.
