WCLC 2025 - Posters & ePosters-P3.14.05 Survival Outcomes of Sequential Therapies in Malignant Pleural Mesothelioma: A Real-World Analysis of Second-Line Treatments

P3.14.05 Survival Outcomes of Sequential Therapies in Malignant Pleural Mesothelioma: A Real-World Analysis of Second-Line Treatments

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This multicenter retrospective real-world study evaluated survival outcomes of second-line therapies in malignant pleural mesothelioma (MPM) patients who progressed after first-line treatment with either ipilimumab-nivolumab (IPI-NIVO) or carboplatin-pemetrexed (CARBO-PEM). The primary aim was to compare progression-free survival (PFS2) and overall survival (OS2) from initiation of second-line treatment with either CARBO-PEM or nivolumab (NIVO).<br /><br />A total of 98 patients were analyzed: 41 received second-line CARBO-PEM and 57 received second-line NIVO, with baseline characteristics balanced between groups. Statistical analysis showed no significant differences in median PFS2 (p=0.437) or OS2 (p=0.554) between these treatments. Furthermore, sequential treatment strategies—IPI-NIVO followed by CARBO-PEM versus CARBO-PEM followed by NIVO—yielded comparable overall survival outcomes (median OS 24.9 months vs. 22.3 months, respectively; p=0.946).<br /><br />Although second-line CARBO-PEM after IPI-NIVO demonstrated a numerically longer PFS2 compared to NIVO following chemotherapy, this difference was not statistically significant. These findings suggest that the choice of second-line therapy may not significantly impact survival outcomes in real-world practice, with both sequential approaches showing similar effectiveness.<br /><br />The study highlights the need for further research, particularly to identify predictive biomarkers that could guide optimal therapeutic sequencing. Limitations include its retrospective design and relatively small sample size, which may affect the robustness of conclusions.<br /><br />In summary, this real-world analysis indicates that second-line CARBO-PEM and NIVO offer comparable survival benefits for MPM patients progressing on first-line IPI-NIVO or CARBO-PEM, emphasizing the importance of personalized treatment strategies and further investigation to optimize management.

Asset Subtitle

Michele Maffezzoli

Meta Tag

Speaker Michele Maffezzoli

Topic Mesothelioma, Thymoma, and Other Thoracic Tumors

Keywords

malignant pleural mesothelioma

second-line therapy

ipilimumab-nivolumab

carboplatin-pemetrexed

progression-free survival

overall survival

real-world study

treatment sequencing

biomarkers

retrospective analysis