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A grandad from Kent says he feels lucky to have taken part in a trial which marks a "major breakthrough" in the treatment of a cancer mostly caused by breathing in asbestos.
People diagnosed with mesothelioma could live for longer when prescribed an immunotherapy drug currently used to treat several other types of cancer, new research has found.
Tony Smith, 70, from Headcorn, was one of 332 people who took part in a trial, which found that an immunotherapy called nivolumab increased survival and made the disease more stable for patients who relapsed following standard treatment.
The CONFIRM trial was led by researchers in Southampton’s clinical trials unit, which is funded by Cancer Research UK, alongside their colleagues in Leicester.
The participants all had tumours which were still growing after receiving chemotherapy and who were not able to have surgery.
Some 221 patients were given nivolumab and the remaining were given a placebo once every fortnight for up to 12 months.
The study is the first to show that a treatment has been able to improve survival in patients with mesothelioma that has come back after chemotherapy.
Until now, no treatment had been found that could significantly improve outcomes for patients.
The findings, which saw those who had nivolumab survive an average of 9.2 months compared to those in the placebo group who survived 6.6 months, were presented to oncologists and researchers around the world at the World Conference on Lung Cancer at the weekend.
Patients who received nivolumab also had more stable disease. The risk of their cancer progressing was reduced by 39%, with people not seeing their cancer worsening for three months compared with 1.8 months in the placebo group.
Mesothelioma develops in the lining of the lungs or abdomen, with most cases caused by exposure to the now outlawed industrial material, asbestos.
Currently seven per cent of people survive their disease for five years or more.
Before starting the trial, Mr Smith's cancer was so advanced he was told major surgery wasn't an option.
However, within three months of starting the trial his cancer had shrunk by 25%.
Although no participants officially know whether they were given the placebo or nivolumab, Mr Smith, a grandad of two, believes he was given the drug.
He said: "The transformation has been just wonderful – truly amazing. I could hardly walk when I started the CONFIRM trial but taking part took me back to how I was pre-diagnosis.
“I don’t know how long it will last but I don’t think about that. It of course stays in the back of your
mind, but I leave it there.”
'The transformation has been wonderful...'
Mr Smith was diagnosed with mesothelioma in 2016 after suffering a collapsed lung.
He volunteered to take part in a trial that would involve surgery, but was told four days before it
was due to take place that his cancer was too advanced and it was no longer possible.
He was then offered the chance to take part in the CONFIRM trial.
He said: “At first they were not sure if I was fit enough but fortunately they let me take part. It was a
bit of a lottery in the sense that you don’t know if you will have the new drug they are testing or the
placebo.”
Mr Smith started the trial in August 2019. A scan three months later showed a huge cent reduction in
his tumour.
He said: “It was amazing, I just couldn’t believe it. My trial nurse came and sat next to me with a big smile on her face to tell me the news. From there it just continued to improve all the time.”
The keen gardener stopped his trial after 21 treatments, in May 2020. His latest scan showed his cancer was stable.
He said: “I feel pretty good really and I can enjoy things I couldn’t before taking part in the trial, like
my garden. The frustrating thing now is that I feel so fit and yet we have been so constrained because of coronavirus."
“I feel lucky to have taken part in research that has not only really helped me but will help other people in the future. It’s wonderful to hear there have been such good results – we should be shouting this from the rooftops.”
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.
Professor Gareth Griffiths, director of the Cancer Research UK Southampton Clinical Trials Unit, said: “This trial shows clear evidence of benefit and marks a major breakthrough in the treatment of mesothelioma, a disease where there are currently very few options for patients when first-line chemotherapy has stopped working and prognosis is often very poor.
“This is the first study ever to show improved survival and we therefore believe that nivolumab could be a game-changer for treating mesothelioma patients in the future.”
Michelle Mitchell, Cancer Research UK’s chief executive, said: “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 (National Institute for Heath and Care Excellence) considers nivolumab as a treatment option, which will give people with mesothelioma precious extra time with their loved ones.”
The trial was Funded by Stand Up To Cancer – a joint fundraising campaign by Cancer Research UK and Channel 4.
