New treatment for asbestos-related cancer

Australians living with inoperable malignant mesothelioma will soon have access to an immunotherapy listed on the Pharmaceutical Benefits Scheme (PBS). The treatment — Opdivo (nivolumab) plus Yervoy (ipilimumab) — is a type of immunotherapy known as a checkpoint inhibitor, which helps to activate the immune system to recognise and attack cancer cells. The treatment will be listed on the PBS from 1 July 2021.

Malignant mesothelioma is a rare and aggressive cancer linked to asbestos exposure. The disease affects the mesothelium — a thin layer of tissue that covers most of the body’s internal organs. The disease starts in the cells of the body’s linings, most commonly the linings of the chest.

Malignant mesothelioma has a five-year survival rate of less than 10%, and approximately 90% of newly diagnosed mesothelioma patients have pleural mesothelioma, which starts in the lining of the lungs.

Medical oncologist Dr Keith Horwood from Greenslopes Private Hospital in Brisbane said the reimbursement of a new therapy represents a significant milestone for Australians living with this devastating disease.

“Each year, between 700–800 Australians are diagnosed with mesothelioma, an aggressive cancer with poor survival rates.

“Although Australia has one of the world’s highest incidence rates of mesothelioma, we have limited PBS-reimbursed treatment options for patients.

“For survival rates to improve, patients must receive timely access to novel treatments, which is why as clinicians we welcome the first reimbursed immunotherapy for mesothelioma,” Dr Horwood said.

More than 90% of Australians living with mesothelioma cite possible or probable exposure to asbestos as the cause of their disease, with men more likely to be diagnosed due to increased workplace exposure to asbestos.

According to Lung Foundation Australia CEO Mark Brooke, “Mesothelioma can lay dormant for decades, taking between 20–60 years to develop after asbestos exposure. This means diagnosis is often delayed and most patients present with advanced or inoperable disease.

“Early diagnosis, support, and access to treatment and care is therefore critical to improving outcomes for Australians living with this rare and aggressive cancer,” Brooke said.

“The PBS listing of the first immunotherapy for inoperable malignant mesothelioma will be warmly received by patients and their families.”

Former butcher, retired construction worker and Gold Coast resident Alan (aged 75 years) wasn’t familiar with the rare and aggressive cancer before being diagnosed with pleural mesothelioma in 2020 after experiencing persistent shortness of breath.

“The first thing I thought when they told me I had mesothelioma was, ‘Geez, that sounds like a country in Europe’.

“I wasn’t prepared for the devastating news that followed. I was in a pretty dark place in the hours after my diagnosis. But then Dr Keith Horwood came in and told me he was going to start me on dual immunotherapy treatment, and I felt like the dark cloud lifted a little. It gave me hope,” Alan said.

“When they told me it was asbestos-related, I eventually traced it back to a butcher shop I renovated in the 1970s. Back then we didn’t know the dangers of asbestos, so it was in everything and was everywhere. It’s just bad luck really.

“I’m very lucky to have so much support around me, especially my amazing wife of nearly 50 years. My three kids and six grandkids all live close by too, so I couldn’t ask for anything more.

“I’ve had 75 good years, and I’m hoping with treatment to get a few more, so I can spend it with my grandkids and watch them grow up,” Alan said.

The Medical Director of Bristol-Myers Squibb Australia and New Zealand, Dr Melinda Munns, said the listing is a significant milestone for Australian patients living with unresectable malignant mesothelioma.

“Today we celebrate the achievement of securing reimbursement for the first immunotherapy for inoperable malignant mesothelioma, bringing a new treatment option to the patient community and their clinicians.”

Opdivo Consumer Medicines Information is available here.

Yervoy Consumer Medicines Information is available here.