Effectiveness of Nivolumab on Sarcomatoid Malignant Pleural Mesothelioma With Eosinophilia and Eosinophilic Pleural Effusion

Our plain-English summary of Effectiveness of Nivolumab on Sarcomatoid Malignant Pleural Mesothelioma With Eosinophilia and Eosinophilic Pleural Effusion, by M. Yamazoe, H. Ozasa, Y.H. Kim (Journal of Thoracic Oncology, 2019).

The study

• Authors: M. Yamazoe, H. Ozasa, Y.H. Kim
• Journal: Journal of Thoracic Oncology
• Published: 2019;14(11):e251-e253
• Type of article: Case report, Letter
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This letter to the editor described one patient. A 66-year-old man was admitted to hospital with a large buildup of fluid around his left lung. A pleural biopsy led to a diagnosis of sarcomatoid malignant pleural mesothelioma, or its desmoplastic subtype. Before treatment, eosinophils (a type of white blood cell) made up 29% of the cells in his pleural fluid and 51% of the white cells in his blood. After one cycle of carboplatin and pemetrexed chemotherapy, a scan showed more pleural thickening even though the fluid had decreased. The doctors judged the chemotherapy ineffective and gave the immunotherapy drug nivolumab. After three cycles, a scan showed less fluid, less pleural thickening and lower tumor activity on PET imaging (maximum standard uptake value 7.7, compared with 9.8 at the first scan). His eosinophil levels improved over time. The article did not report any asbestos exposure. The authors concluded that nivolumab may be effective against sarcomatoid malignant pleural mesothelioma with eosinophilic pleural effusion even if cytotoxic chemotherapy is ineffective. A single case shows what happened to one patient, not how often such a response occurs.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case report (letter to the editor) describing one patient
• Who was studied: One 66-year-old man with sarcomatoid malignant pleural mesothelioma, eosinophilia and eosinophilic pleural effusion. The authors are from the Department of Respiratory Medicine, Kyoto University. The article does not give dates.
• Exposure: The article studied treatment, not asbestos exposure. The patient received carboplatin and pemetrexed chemotherapy and then nivolumab (3 mg/kg). The article reports no asbestos or other occupational exposure.
• Main results:
  • The patient's tumor was diagnosed as sarcomatoid malignant pleural mesothelioma, or as desmoplastic malignant pleural mesothelioma, a subtype of the sarcomatoid type.
  • Before chemotherapy, the patient's pleural fluid showed an increased eosinophil fraction of 29%.
  • Before chemotherapy, the patient's peripheral blood showed an increased eosinophil fraction of 51%.
  • After one cycle of carboplatin and pemetrexed, chest CT showed an increase in left pleural thickening despite a decrease in left pleural effusion.
  • At the first PET-CT, the patient's mass showed a maximum standard uptake value of 9.8.
  • After three cycles of nivolumab, PET-CT showed decreased left pleural effusion and decreased left pleural thickening, with lower FDG uptake (maximum standard uptake value 7.7).
  • The patient's eosinophilia improved over time.
• The authors' conclusion: The authors concluded that nivolumab may be effective against sarcomatoid malignant pleural mesothelioma with eosinophilic pleural effusion even if cytotoxic chemotherapy is ineffective.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Nivolumab (Opdivo), Sarcomatoid, Pleural Mesothelioma, Eosinophilic, Pleural Effusion.

Related studies

• Nivolumab or nivolumab plus ipilimumab in patients with relapsed malignant pleural mesothelioma (IFCT-1501 MAPS2): a multicentre, open-label, randomised, non-comparative, phase 2 trial — A. Scherpereel, J. Mazieres, et al. (2019)
• Programmed Death 1 Blockade With Nivolumab in Patients With Recurrent Malignant Pleural Mesothelioma — J. Quispel-Janssen, V. van der Noort, et al. (2018)
• CONFIRM: a double-blind, placebo-controlled phase III clinical trial investigating the effect of nivolumab in patients with relapsed mesothelioma: study protocol for a randomised controlled trial — D.A. Fennell, E. Kirkpatrick, et al. (2018)
• Ipilimumab/Nivolumab-related Opsoclonus-Myoclonus-Ataxia Syndrome Variant in a Patient with Malignant Pleural Mesothelioma — B. Maller, E. Peguero, et al. (2018)
• Nivolumab for malignant peritoneal mesothelioma — T. Tanaka, Y. Miyamoto, et al. (2020)
• Eosinophilic pleural effusions — I. Kalomenidis, R.W. Light (2003)

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