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. 2022 Mar 15;14(6):1498.
doi: 10.3390/cancers14061498.

Immune-Checkpoint Inhibitors for Malignant Pleural Mesothelioma: A French, Multicenter, Retrospective Real-World Study

Jean-Baptiste Assié  1   2 , Florian Crépin  3 , Emmanuel Grolleau  4 , Anthony Canellas  5 , Margaux Geier  6 , Aude Grébert-Manuardi  7 , Nabila Akkache  8 , Aldo Renault  9 , Pierre-Alexandre Hauss  10 , Marielle Sabatini  11 , Valentine Bonnefoy  1 , Alexis Cortot  3 , Marie Wislez  12   13 , Clément Gauvain  3 , Christos Chouaïd  1 , Arnaud Scherpereel  3 , Isabelle Monnet  1
Affiliations

Immune-Checkpoint Inhibitors for Malignant Pleural Mesothelioma: A French, Multicenter, Retrospective Real-World Study

Jean-Baptiste Assié et al. Cancers (Basel). .

Abstract

Backgrounds: Malignant pleural mesothelioma (MPM) is a cancer with poor prognosis. Second-line and onward therapy has many options, including immune-checkpoint inhibitors with demonstrated efficacy: 10−25% objective response rate (ORR) and 40−70% disease-control rate (DCR) in clinical trials on selected patients. This study evaluated real-life 2L+ nivolumab efficacy in MPM patients and looked for factors predictive of response. Methods: This retrospective study included (September 2017−July 2021) all MPM patients managed in 11 French centers. Results: The 109 enrolled patients’ characteristics were: median age: 69 years; 67.9% men; 82.6% epithelioid subtype. Strictly, second-line nivolumab was given to 51.4%. Median PFS and OS were 3.8 (3.2−5.9) and 12.8 (9.2−16.4) months. ORR was 17/109 (15.6%); 34/109 patients had a stabilized disease (DCR 46.8%). Univariable analysis identified several parameters as significantly (p < 0.05) prognostic of OS [HR (95% CI)]: biphasic subtype: 3.3 (1.52−7.0), intermediate Lung Immune Prognostic Index score: 0.46 (0.22−0.99), progression on the line preceding nivolumab: 2.1 (1.11−3.9) and age > 70 years: 2.5 (1.5−4.0). Multivariable analyses retained only biphasic subtype: 3.57 (1.08−11.8) and albumin < 25 g/L: 10.28 (1.5−70.7) as significant and independent predictors. Conclusions: Second-line and onward nivolumab is effective against MPM in real life but with less effectiveness in >70 years. Ancillary studies are needed to identify the predictive factors.

Keywords: immune-checkpoint inhibitors; malignant pleural mesothelioma; nivolumab; real-world study; second-line regimen.

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Conflict of interest statement

For the past 5 years, C.C. has received fees for attending scientific meetings, speaking, organizing research or consulting from AZ, BI, GSK, Roche, Sanofi Aventis, BMS, MSD, Lilly, Novartis, Pfizer, Takeda, Bayer, Janssen and Amgen. M.G. has consultancy and advisory boards for AstraZ, BMS, MSD, Pfizer, Chugai, Sanofi and meetings with MSD, Roche and BMS; C.G. has non-financial supports from Merck Sharp and Dohme; A.C. (Alexis Cortot) has consultancy for BMS, MSD, Astra Zeneca and Roche; P.-A.H. received fees for attending scientific meetings with Chiesi, Roche, Boehringer ingelheim, Novartis pharma, Pfizer, Asten Sante and Bristol Meyer Squibb; V.B., F.C., E.G., J.-B.A., M.W., A.C. (Anthony Canellas) and A.S. have no conflict of interests.

Figures

Figure 1
Figure 1
Kaplan–Meier estimated probabilities of (A) PFS and (B) OS for the entire cohort.
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