Immunotherapy — anyone tried Keytruda + Opdivo combination?

David, the nivolumab plus ipilimumab combination (CheckMate 743) is indeed now the first-line standard of care for unresectable pleural mesothelioma, regardless of cell type. It was FDA-approved based on a significant improvement in overall survival compared to chemotherapy alone.

Common side effects to watch for:
- Fatigue (very common, usually manageable)
- Skin rash or itching
- Diarrhea or colitis (important to report early)
- Thyroid changes (your doctor will monitor blood work)
- Liver inflammation (monitored through blood tests)

The key with immunotherapy side effects is early reporting. Most can be managed effectively if caught early, but some (particularly colitis and pneumonitis) require prompt treatment with steroids.

Many patients tolerate this combination quite well, and some have durable responses lasting years. The biphasic cell type actually showed particular benefit in the trial compared to historical chemotherapy results.

Stay in close communication with your oncology team about any new symptoms.