WCLC 2025 - Posters & ePosters-P3.14.11 Real-World Outcomes and Toxicity of First-Line Dual Immunotherapy in Unresectable Pleural Mesothelioma

P3.14.11 Real-World Outcomes and Toxicity of First-Line Dual Immunotherapy in Unresectable Pleural Mesothelioma

Pdf Summary

This retrospective study evaluated real-world incidence and management of adverse events (AEs) in patients with unresectable pleural mesothelioma (PM) treated with first-line dual immunotherapy Nivolumab/Ipilimumab (N/I) at Princess Margaret Cancer Centre between 2020-2023. Data from 41 patients were abstracted from electronic medical records, with toxicity graded by CTCAE v5.0. Immune-related adverse events (irAEs) were categorized into laboratory abnormalities only versus symptomatic events, and steroid use for irAE management was described. <br /><br />Key findings indicate that the toxicity profile in this cohort was similar to that reported in the Checkmate 743 trial, which previously showed 30% of patients experience grade 3 treatment-related AEs. Steroid therapy and hospitalizations were commonly required for irAE management. Notably, patients experiencing irAEs had a significantly longer median overall survival (mOS) of 27.2 months versus 11.7 months for those without irAEs (hazard ratio 0.29, p=0.005). The overall median survival in the cohort was 20.1 months.<br /><br />This real-world evidence supports that first-line N/I is a manageable regimen for unresectable PM with toxicity consistent with clinical trials. The association of irAEs with improved survival suggests immune activation correlates with therapeutic benefit. These findings underscore the importance of vigilant AE monitoring and prompt intervention with steroids to manage irAEs and support patient outcomes. Further prospective studies may clarify mechanisms linking irAEs and survival in PM treated with dual immune checkpoint blockade.

Asset Subtitle

Beatriz Jimenez Munarriz

Meta Tag

Speaker Beatriz Jimenez Munarriz

Topic Mesothelioma, Thymoma, and Other Thoracic Tumors

Keywords

unresectable pleural mesothelioma

Nivolumab

Ipilimumab

dual immunotherapy

immune-related adverse events

steroid therapy

overall survival

toxicity profile

real-world evidence

immune checkpoint blockade