Leicester leads major breakthrough in asbestos linked cancer

A University of Leicester led team has made a major breakthrough in treating mesothelioma, an aggressive form of cancer linked to breathing in asbestos, which could help add years to patients’ lives.

The CONFIRM trial demonstrated for the first time that use of nivolumab, an immunotherapy drug, increased survival and stabilised the disease for patients who relapsed following chemotherapy.

The findings saw those who had nivolumab survive an average of 9.9 months compared to those in the placebo group who survived 6.6 months (50% longer). Currently only seven per cent of people survive five years after diagnosis.

Co-led by Professor Dean Fennell, Chair of Thoracic Medical Oncology at the University of Leicester and Director of the Leicester Mesothelioma Research Programme, said:

“Asbestos might seem like a threat of the past, but for many, it’s left quite literal scars that are only being seen now. Mesothelioma is a relatively rare disease, but it is a devastating one. We wanted to do anything we could to find better treatments for these patients, despite being in the midst of a global pandemic. The fact that we could set up and run this trial during COVID-19 is largely owed to the resilience of the patients who took part. 

“The CONFIRM trial gives clear evidence that if nivolumab was made available in the long-term for the treatment of our mesothelioma patients, it could improve the lives of those already suffering with the disease and those who will sadly discover they have it as cases rise in years to come. This represents a major breakthrough and could be a game-changer for treating mesothelioma patients in the future.”
Michelle Mitchell, Cancer Research UK’s chief executive, said:

“Nearly half a century ago, Cancer Research UK scientists added to the understanding of just how dangerous asbestos could be. This research helped change regulations, reducing workers exposure to this deadly substance. But mesothelioma can take over 40 years to develop, and the long and painful legacy of asbestos use is still sadly being felt today.

“It’s wonderful news to hear that we may have found a new treatment for people with mesothelioma who have run out of options, when there has been so little progress over the years. We hope that NICE considers nivolumab as a treatment option, which will give people with mesothelioma precious extra time with their loved ones.”

Mesothelioma develops in the lining of the lungs or abdomen, with most cases caused by exposure to the now outlawed industrial material, asbestos.

Each year, around 25 people are diagnosed with mesothelioma in Leicestershire and 190 are diagnosed in the East Midlands. Cases of mesothelioma in the UK have increased by 61% since the early 1990s.

People with mesothelioma are usually treated with chemotherapy, surgery or radiotherapy. But treatment options start to become limited once people stop responding to their treatment.

A total of 332 patients whose tumours were still growing after receiving chemotherapy and who were not able to have surgery, took part in the randomised trial. A total of 221 of those patients were given nivolumab and the remaining 111 given a placebo once every fortnight for up to 12 months. Eighty-five of the patients who took part in the trial were treated at the Hope Cancer Trials Centre at University Hospitals of Leicester NHS Trust.

During the COVID-19 pandemic, NHS England endorsed nivolumab for use in some people with malignant mesothelioma as an alternative to chemotherapy because it has less of a suppressive effect on the immune system and may reduce the risk of someone becoming seriously ill during the pandemic. This decision is currently in place until the end of March but the data from the CONFIRM trial could help to make this option permanently available to patients.

Since its launch in 2012, Stand Up To Cancer has raised over £62 million to fund 55 clinical trials and research projects involving around 11,000 cancer patients across the UK.