Immunotherapy, mesothelioma and the pandemic
The pandemic has had a considerable impact on the treatment of non-COVID-19 conditions and for which, it is estimated, there will be a massive excess death count.
People with respiratory disease, including asbestos related cancers and mesothelioma, were advised to shield to avoid catching the virus and, in so doing, may have missed out on crucial treatment.
A leading respiratory expert has confirmed that some chemotherapy treatments were put on hold during the peak months for many cancer sufferers and we have all read news stories of people whose lives were lost as a result of missed treatment.
In relation to asbestos related injury claims, there have been issues with diagnoses being confirmed and medico-legal experts, understandably, have been unable to see claimants for examinations and reporting. As we now head towards the next wave, it is likely that further delays will ensue, both in relation to treatment and in the litigation process.
However, in the midst of the doom there have been some promising developments in relation to immunotherapy. Of considerable relevance to both sufferers and those dealing with their claims is the news that the National Institute for Health and Care Excellence (NICE) have approved the use of nivolumab in second line treatment for mesothelioma. Second line refers to relapsed cases. The rationale behind this approval appears to be that immunotherapy, when compared to chemotherapy, decreases the risk of admission to hospital with infections caused by the immunosuppressant nature of chemotherapy and decreases the risk of severe COVID-19. The approval for this immunotherapy treatment is to be re-evaluated in April 2021 and, by which time it is hoped that there will be an improving situation as far as the pandemic is concerned
The Check-Mate 743 trial results were reported to the International Association for the Study of Lung Cancer World Conference earlier this year. The trial involved giving mesothelioma sufferers treatment of either a combination of nivolumab and ipilimubab or chemotherapy as a first line treatment. The results showed that those having the combined immunotherapy had an overall survival median of 18.1 months compared to 14.1 months with the chemotherapy. The study also showed that the immunotherapy achieved better results with those in the non-epithelioid sub-group and future trials will need to be created to try and better understand the way in which mesothelioma responds to or is resistant to immunotherapy treatments.
For those dealing with claims, there will undoubtedly be costs implications in relation to future treatment costs. We have experienced a raft of issues relating to final orders and whether these costs are dealt with by way of indemnity, trust or simply by adjourning until such time as the treatment need and type is identified. Careful consideration continues to be necessary to ensure fairness and reasonableness is achieved.
Read others items in Occupational Disease Brief - November 2020