Is there a role for immunotherapy in malignant pleural mesothelioma?

Our plain-English summary of Is there a role for immunotherapy in malignant pleural mesothelioma?, by A. Tartarone, R. Lerose, M. Aieta (Medical Oncology, 2018).

The study

• Authors: A. Tartarone, R. Lerose, M. Aieta
• Journal: Medical Oncology
• Published: 2018;35(7):98
• Type of article: Review
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant pleural mesothelioma (MPM) is a very aggressive malignancy, mainly caused by asbestos exposure. Patients with MPM have a poor prognosis that remained substantially unchanged in the last few years and limited effective therapeutic options with no recognized second or further-line therapy. In this context, also in view of the positive results observed in other tumor types, immunotherapy could play a relevant role. This review focuses on the most promising immunotherapies being investigated in MPM.

In plain English

This article was a review, not a new study. The authors summarized clinical trials of immunotherapy for malignant pleural mesothelioma, a cancer they described as mainly caused by asbestos exposure. They did not study asbestos exposure themselves. They reviewed immune checkpoint inhibitor drugs, and briefly covered mesothelin-targeting drugs, CAR T cells and vaccines. The DETERMINE trial they described, which compared tremelimumab with placebo in 658 previously treated patients, did not meet its main goal, which was overall survival. In the trials of previously treated patients they cited, pembrolizumab produced partial responses in 5 of 25 patients (20%) in one trial and in 21% of 34 patients in another. In the MAPS-2 trial, disease control at 12 weeks was 50% with ipilimumab plus nivolumab and 44% with nivolumab alone. Grade 3 to 4 treatment-related side effects were more common in the combination group (26.2% vs 12.7%), and that group had 3 treatment-related deaths. The authors concluded that immunotherapy could play a role in this cancer.

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: Review article summarizing published and conference-reported clinical trials of immunotherapy in malignant pleural mesothelioma
• Who was studied: No patients were studied directly. The review covered clinical trials of patients with malignant pleural mesothelioma, some of which also included peritoneal mesothelioma.
• Exposure: Not an asbestos exposure study. The treatments reviewed were immunotherapies: immune checkpoint inhibitors (tremelimumab, pembrolizumab, nivolumab, avelumab, ipilimumab, durvalumab), mesothelin-targeting drugs, CAR T cells and vaccines. Asbestos is mentioned only as the main cause of the disease.
• Main results:
  • DETERMINE trial (as reviewed): this randomized, placebo-controlled trial of tremelimumab included 658 pretreated patients with pleural (95%) or peritoneal mesothelioma. It did not meet its primary endpoint of overall survival.
  • Keynote-028 trial (as reviewed): among 25 previously treated MPM patients given pembrolizumab, 5/25 (20%) had a partial response and 13/25 (52%) had stable disease.
  • Kindler et al. trial (as reviewed): pembrolizumab in 34 previously treated patients with malignant mesothelioma (86% pleural, 14% peritoneal) gave 21% partial responses, with median progression-free survival of 6.2 months and median overall survival of 11.9 months.
  • Mauti et al. (as reviewed): in 95 MPM patients treated with pembrolizumab outside clinical trials in Switzerland and Australia, the overall response rate was 19%, median progression-free survival 3.1 months and median overall survival 7.2 months.
  • MAPS-2 trial (as reviewed): in pretreated MPM patients, disease control at 12 weeks was 50% with ipilimumab plus nivolumab versus 44% with nivolumab alone.
  • MAPS-2 trial (as reviewed): grade 3 to 4 treatment-related side effects occurred in 26.2% of the combination group versus 12.7% of the nivolumab-alone group, with 3 treatment-related deaths in the combination group.
• The authors' conclusion: The authors concluded that immunotherapy could play a role in malignant pleural mesothelioma.

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: Immunotherapy, Pleural Mesothelioma, Asbestos Exposure, Prognosis.

Related studies

• Emerging avenues in immunotherapy for the management of malignant pleural mesothelioma — S.G. Gray (2021)
• Exposing Hidden Targets: Combining epigenetic and immunotherapy to overcome cancer resistance — K. Olino, T. Park, et al. (2020)
• Anti-CTLA-4 therapy for malignant mesothelioma — A. Guazzelli, E. Bakker, et al. (2017)
• Network analysis of immunotherapy-induced regressing tumours identifies novel synergistic drug combinations — W.J. Lesterhuis, C. Rinaldi, et al. (2015)
• Mesothelin Immunotherapy for Cancer: Ready for Prime Time? — R. Hassan, A. Thomas, et al. (2016)
• Systemic approach to malignant pleural mesothelioma: what news of chemotherapy, targeted agents and immunotherapy? — D. Signorelli, M. Macerelli, et al. (2016)

Browse more research in Medical Oncology, or return to medical research.