Paul Baas, MD, PhD, chief, Department of Thoracic Oncology, Netherlands Cancer Institute, discusses the benefits of immunotherapy in subpopulations of patients with mesothelioma. 

The phase 3 CheckMate743 trial (NCT02899299) investigated frontline nivolumab (Opdivo) plus ipilimumab (Yervoy) vs chemotherapy in patients with unresectable pleural mesothelioma. In an updated 3-year analysis of these data, the median overall survival (OS) in patients with non-epithelioid histology who received the immunotherapy combination was 18.1 months vs 8.8 months in the chemotherapy arm. 

Patients with non-epithelioid mesothelioma have historically demonstrated unfavorable OS rates, Baas says. Although OS improved slightly with the introduction of chemotherapy in this population, immunotherapy, as shown in CheckMate743, improved OS by 9.3 months, Baas explains. 

Immunotherapy is beneficial for patients with non-epithelioid mesothelioma and should be offered to patients who have no contraindications, Baas highlights. Although this OS benefit was slightly less pronounced in the epithelioid population, it was still favorable in this subgroup, Baas says. Overall, the patients studied in this trial showed interesting and encouraging survival rates, Baas concludes. 

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Paul Baas, MD, PhD, discusses the benefits of immunotherapy in subpopulations of patients with mesothelioma. 

Dr. Baas on Immunotherapy in Mesothelioma Subpopulations

Paul Baas, MD, PhD, a professor within the Department of Thoracic Oncology at the Netherlands Cancer Institute, discusses recent updates in immuno-oncology within the field of mesothelioma.

For mesothelioma, a few interesting developments have been made in recent years, says Baas. For 50 years, chemotherapy continued to be the standard in the space. Mesothelioma is a very aggressive disease with poor survival outcomes. Recently, however, there has been an interest in examining the use of immuno-oncology drugs within the field of mesothelioma.

To this end, a few reports of this approach in the second-line setting have been reported; these reports have implied that if 1 drug is used, such as pembrolizumab (Keytruda) or nivolumab (Opdivo), they will not show a great deal of activity, says Baas. Although these findings were a bit disappointing, some data examining nivolumab and ipilimumab (Yervoy) suggest that a combination approach might yield more promising results, says Baas.

A press release issued in April 2020 from Bristol Myers Squibb announced positive results from a first-line study comparing immune checkpoint inhibitors versus chemotherapy in patients with mesothelioma. These data will be presented at the 2020 World Lung Conference during the Presidential Symposium and might change the first-line approach for patients; this is important news for immuno-oncology, adds Baas.

Additionally, the combination of chemotherapy with durvalumab (Imfinzi) in a single-arm study showed a favorable median overall survival (OS) of 20 months; these are quite interesting findings because normally the median OS that is reported in this space is 15 months or a maximum of 16 months, concludes Baas.

Paul Baas, MD, PhD, discusses recent updates in immuno-oncology within the field of mesothelioma.

Dr. Baas on the Promise of Immuno-Oncology in Mesothelioma

Paul Baas, MD, PhD, thoracic oncologist in the Division of Medical Oncology of the Netherlands Cancer Institute in Amsterdam, discusses the standard of care for mesothelioma patients.

Baas describes the current standard, platinum with an antifolate, as successful at first but does not have long-term benefits beyond 2 years.

There are currently 2 phase III studies investigating mesothelioma treatment. The first study was presented at ASCO and failed to produce results. Another study that will be presented at ESMO looks at recurrent mesothelioma.

New treatments for mesothelioma are constantly being investigated because asbestos is still commonly used in third world countries that do not have any rules or regulations against its use.

Dr. Paul Baas from the Netherlands Cancer Institute on the Standard of Care for Mesothelioma Patients

Paul Baas, MD, PhD

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Dr. Baas on Immunotherapy in Mesothelioma Subpopulations

Dr. Baas on the Promise of Immuno-Oncology in Mesothelioma

Dr. Baas on the Standard of Care for Mesothelioma Patients