First-line nivolumab plus ipilimumab in unresectable malignant pleural mesothelioma (CheckMate 743): a multicentre, randomised, open-label, phase 3 trial
RCT (n=605) found nivolumab plus ipilimumab significantly extended overall survival vs chemotherapy (median overall survival 18·1 months vs 14·1 months, HR 0·74, p=0·0020). 2-year overall survival rates were 41% in the nivolumab plus ipilimumab group and 27% for chemotherapy.
Source:
The Lancet
SPS commentary:
A related editorial comments that this study represents a turning point in the treatment of unresectable malignant pleural mesothelioma (MPM) and supporting a new standard of care in this population. However, as in other thoracic cancers, the long-term benefit of immunotherapy in MPM appears to be limited to a small fraction of patients. Longer follow-up and translational studies, including assessment of circulating immune cells and cytokines, will shed more light on predictors of treatment efficacy. Ongoing trials exploring the addition of chemotherapy and antiangiogenics to immune checkpoint inhibitors will assess a potential extension of survival benefit to a larger group of patients with MPM, particularly those with epithelioid histology, thus possibly leading to treatment stratification in different histological subtypes.