Immunotherapy for mesothelioma

The immune system protects the body against illness and infection. Immunotherapies are treatments that use the immune system to find and attack cancer cells.

You may be offered immunotherapy to treat pleural or peritoneal mesothelioma. It is usually used as a first treatment for pleural mesothelioma.

The most common immunotherapy drugs used for mesothelioma are called nivolumab and ipilimumab. They are usually given together. These drugs are also called checkpoint inhibitors or CPIs.

Sometimes nivolumab may be offered on its own to some people who have pleural mesothelioma and who already had chemotherapy and need further treatment.

Your cancer team will explain if this treatment is suitable for you.

Checkpoint inhibitor drugs can have a range of side effects. Your cancer team will give you information about possible side effects before you start treatment. You may get some of the side effects but you are unlikely to get all of them.

Your cancer team will monitor you regularly during and after treatment. They can give you drugs to help control some side effects and advice on how to manage them. It is important to take any drugs exactly as explained. This means they will be more likely to work for you.

Immunotherapy drugs can attack healthy tissue and make the immune system react. This can cause inflammation in different organs of the body. Sometimes this causes very serious side effects called immune related side effects.

Your doctor, nurse or pharmacist will explain the possible side effects and what to do if you have any. It is very important to know about them so you can contact the hospital straight away. You will need to be treated quickly. Do not try to treat this type of side effect yourself.

Some of the organs or parts of the body that might be affected include:

• the liver
• the lungs
• the bowel
• the kidneys
• glands that make certain hormones
• the joints
• the skin.

If you think you have any of these side effects, contact the hospital straight away on the 24-hour number you have been given.

Immune system side effects can start in the first weeks or months of treatment. But sometimes they happen up to 2 years after treatment has finished.

Sometimes your doctor may delay treatment until side effects improve. If you have serious side effects your doctor may advise stopping the treatment. They can talk to you about other possible treatment options.

Your doctor, nurse or pharmacist will give you 24-hour contact numbers for the hospital. If you feel unwell or need advice, you can call at any time of the day or night. Save these numbers in your phone or keep them somewhere safe.

Sometimes side effects can become serious very quickly. Always contact the hospital straight away for advice.

Always have your patient alert card with you during treatment and after treatment ends.