Durvalumab Hopes to be Treatment Option for Malignant Pleural Mesothelioma

According to a recent article from OncologyLive, investigators are looking at durvalumab to aid in the treatment of adults with malignant pleural mesothelioma in the Phase 3 DREAM3R Trial.

Malignant Pleural Mesothelioma

Malignant pleural mesothelioma (MPM) is the most common form of mesothelioma, forming in the pleura in the lungs. It accounts for about 75% of all cases.


Many people do not notice any symptoms until later in disease development. When they do appear they include:

  • Shortness of breath
  • Chest pain
  • Painful breathing
  • Difficulty swallowing
  • Coughing up blood
  • Night sweats
  • Fever
  • Pain in the lower back and/or ribs
  • Lumps under the skin on the chest
  • Fatigue
  • Weight loss
  • Swelling in the arms and/or face

Phase 3 DREAM3R Trial

In this trial, investigators are hoping to boost systemic therapy options for patients who are diagnosed with malignant pleural mesothelioma. The study looks at durvalumab to see if it is safe and effective as a treatment option. It is evaluated as a treatment in combination with the standard chemotherapy regimen of cisplatin and pemetrexed (CP).

This study is open-label, meaning both the health providers and patients are aware of the drug or treatment that is being given. It is a randomized study that will enroll around 480 patients who have never undergone treatment for their malignant pleural mesothelioma.  Since the study is randomized, patients will either receive durvalumab with the standard treatment of CP or they will have standard chemotherapy only.

Those in the durvalumab group will receive 1500 mg doses every 3 weeks, with the addition of 75 mg/m2 of standard cisplatin and 500 mg/m2 of pemetrexed every 3 weeks. They will be given in 4 to 6 cycles, followed by 1500 mg of durvalumab given every 4 weeks. The control group will receive only their standard chemotherapy at the same dose as the other group for 4 to 6 cycles.

Patients will receive treatment until they experience disease progression, reach an unacceptable level of toxicity, or the patients decides to withdraw. Assessments will be done to determine quality-of-life and tumor progressions frequently.

The trial’s primary end-point is at the overall survival of the patient. The other end-points are progression-free survival, objective tumor response, and safety. The trial is estimated to be completed in December of 2025.

If this trial and future research yield positive results, we could be looking at a new option for first-line treatment. Hopefully, this research demonstrates that there’s a survival benefit to adding immunotherapy to chemotherapy.

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