2023 World Conference on Lung Cancer (Posters)-EP14.01. Neo-Adjuvant Immunotherapy in Malignant Pleural Mesothelioma: Report on Three Cases Treated in a Single Institution

EP14.01. Neo-Adjuvant Immunotherapy in Malignant Pleural Mesothelioma: Report on Three Cases Treated in a Single Institution - PDF(Slides)

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This report discusses three cases of malignant pleural mesothelioma (MPM) patients treated with neoadjuvant immunotherapy. MPM is typically treated with cisplatin and pemetrexed, but recent trials have shown the potential benefits of immunotherapy. The CheckMate-743 trial demonstrated a 26% reduction in mortality and a 2-year survival rate of 41% with the use of Nivolumab plus Ipilimumab compared to chemotherapy alone. However, there are limited reports on the use of immunotherapy in a neoadjuvant setting, which is why these cases are being presented.<br /><br />In the first case, a 68-year-old male with epithelioid MPM received standard neoadjuvant chemotherapy but showed disease progression on restaging. The patient then underwent combined immunotherapy and achieved a metabolic response. They were eligible for surgery and had a complete response with no evidence of disease relapse after one year.<br /><br />The second case involved a 55-year-old male with epithelioid MPM who received neoadjuvant immunotherapy and had a partial disease response. The patient underwent surgery and post-operative histology confirmed a biphasic MPM. However, the patient experienced local relapse after 12 months and pleural and peritoneal progression after 18 months.<br /><br />In the third case, a 69-year-old male with biphasic MPM received combined immunotherapy but had to stop after four cycles due to disease progression. The patient was then administered systemic chemotherapy.<br /><br />Overall, the results of these cases showed a heterogeneous response to immunotherapy. Epithelioid MPM had a complete response, which is not commonly achieved with chemotherapy alone. However, progression and post-surgical relapse were observed in biphasic MPM. The report suggests the need to identify subtypes of mesothelioma that may have a better response to immunotherapy. Comprehensive transcriptomic characterization of tissue samples is ongoing to help determine the determinants for double immunotherapy in the multimodality treatment strategy. Additionally, the role of surgery should be investigated in an integrated treatment approach.<br /><br />These findings highlight the potential benefits of neoadjuvant immunotherapy in MPM and the need for further research to optimize treatment strategies.

Asset Subtitle

Pierluigi Novellis

Meta Tag

Speaker Pierluigi Novellis

Topic Mesothelioma, Thymoma & Other Thoracic Tumors

Keywords

malignant pleural mesothelioma

neoadjuvant immunotherapy

CheckMate-743 trial

Nivolumab

Ipilimumab

epithelioid MPM

biphasic MPM

complete response

disease relapse

chemotherapy