Related Experiment Video
Updated: Feb 8, 2026
Generation and Expansion of Primary, Malignant Pleural Mesothelioma Tumor Lines
Published on: April 21, 2022
Programmed Death 1 Blockade With Nivolumab in Patients With Recurrent Malignant Pleural Mesothelioma
Josine Quispel-Janssen1, Vincent van der Noort2, Jeltje F de Vries2
1Department of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
Introduction:
Malignant pleural mesothelioma (MPM) has limited treatment options and a poor outcome. Programmed death 1/programmed death ligand 1 (PD-L1) checkpoint inhibitors have proven efficacious in several cancer types. Nivolumab is a fully humanized monoclonal antibody against programmed death 1 with a favorable toxicity profile. In MPM, the immune system is considered to play an important role. We therefore tested nivolumab in recurrent MPM.
Methods:
In this single-center trial, patients with MPM received nivolumab 3 mg/kg intravenously every 2 weeks. Primary endpoint was the disease control rate at 12 weeks. Pre- and on-treatment biopsy specimens were obtained to analyze biomarkers for response.
Results:
Of the 34 patients included, 8 patients (24%) had a partial response at 12 weeks and another 8 had stable disease resulting in a disease control rate at 12 weeks of 47%. One reached a partial response at 18 weeks. In 4 patients with stable disease, the tumor remained stable for more than 6 months. Treatment-related adverse events of any grade occurred in 26 patients (76%), most commonly fatigue (29%) and pruritus (15%). Grades 3 and 4 treatment-related adverse events were reported in 9 patients (26%), with pneumonitis, gastrointestinal disorders, and laboratory disorders mostly seen. One treatment-related death was due to pneumonitis and probably initiated by concurrent amiodarone therapy. PD-L1 was expressed on tumor cells in nine samples (27%), but did not correlate with outcome.
Conclusions:
Single-agent nivolumab has meaningful clinical efficacy and a manageable safety profile in pre-treated patients with mesothelioma. PD-L1 expression does not predict for response in this population.
Insights
Nivolumab showed clinical efficacy in recurrent malignant pleural mesothelioma (MPM), achieving a 47% disease control rate. Programmed death ligand 1 (PD-L1) expression did not predict response in this patient group.
Area of Science:
- Oncology
- Immunotherapy
- Thoracic Surgery
Background:
- Malignant pleural mesothelioma (MPM) presents limited therapeutic avenues and a grim prognosis.
- Programmed death 1 (PD-1) and programmed death ligand 1 (PD-L1) checkpoint inhibitors have demonstrated effectiveness in various cancers.
- Nivolumab, an anti-PD-1 monoclonal antibody, exhibits a favorable safety profile and is being investigated for MPM.
Purpose of the Study:
- To evaluate the efficacy and safety of nivolumab as a monotherapy in patients with recurrent malignant pleural mesothelioma.
- To assess the correlation between PD-L1 expression and treatment response in MPM patients receiving nivolumab.
Main Methods:
- A single-center trial involving 34 patients with recurrent MPM treated with nivolumab (3 mg/kg IV every 2 weeks).
- The primary endpoint was the disease control rate at 12 weeks.
- Biopsies were collected pre- and on-treatment to analyze biomarkers for response.
Main Results:
- The overall disease control rate at 12 weeks was 47% (8 partial responses, 8 stable disease).
- Treatment-related adverse events occurred in 76% of patients; Grade 3/4 events in 26%.
- PD-L1 expression on tumor cells (27% of samples) did not correlate with treatment outcomes.
Conclusions:
- Single-agent nivolumab demonstrates significant clinical efficacy and a manageable safety profile in pre-treated MPM patients.
- PD-L1 expression is not a reliable predictor of response to nivolumab in this population.
- Further research into biomarkers and combination therapies for MPM is warranted.
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