There seem to be a number of CheckMate trials going on both in Britain and Globally. It’s obviously a wonderful soundbite, but is the double immunotherapy wonderful in reality?
For example, ‘First line Nivolumab (a PD-1 immunotherapy), plus ipilimumab (a PD-L1 immunotherapy) has shown improved overall survival in patients with advanced non-small-cell lung cancer (NSCLC)' (1). But the word checkmate surely means more than simply beating the previously used drugs, so the researchers have gone on to use two platinum based chemotherapy drugs as well for two rounds with the immunotherapy drugs, or 4 rounds alone.
This was in a Phase III trial in 103 Hospitals in 19 countries; 1107 patients. Serious stuff. Median survival went to 14.1 months from 10.7 months. Being a chess player, I’m not sure that qualifies for the term ‘Checkmate’.
Now the reason I have had a little look at this is that I have been helping two people who were both on the two immunotherapy drugs, and they both had to stop after 3 rounds because they had severe liver problems. Severe as in 2 months on Prednisolone and they are still in serious trouble. One has NSCLC and the other Mesothelioma. They both talked to me in the last 10 days. Curiously their oncologists told them they didn’t really understand why these men had reacted so badly, and that in each case, the patient was the only example he had come across.
Maybe it is just a coincidence?
Then I opened my mail today to find a third patient (NSCLC) in exactly the same state. Again told he was the only person it has happened to. He was taking none of my ‘mumbo jumbo’ - we were going to start when the trial ended.
Notwithstanding that I think most oncologists in the UK don’t know how to use an immunotherapy properly by preparing the patient’s gut (you can see what I wrote about making PD-1 work better, below), I was worried about these men so I checked side-effects.
In the study I reference above, hepatitis was just one of the problems; kidney failure led the way. And interestingly under side-effects was death - about 7 people in this study.
So, 0.7% of people taking these two immunotherapy drugs die. That certainly is Check Mate.
But hang on. 0.7% is roughly the same number of people who die overall having caught Covid, and much higher than people dying from Covid under 50. So why is this a big deal when it comes to Covid-19 vaccines, but not when you simultaneously take two immunotherapy drugs?
Go figure.
Go to: How to make your immunotherapy drugs work better
Go to: Transarterial chemoperfusion give some hope to mesothelioma patients
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References
- https://pubmed.ncbi.nlm.nih.gov/33476593/#affiliation-1