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Updated: Sep 22, 2025
Orthotopic Implantation and Peripheral Immune Cell Monitoring in the II-45 Syngeneic Rat Mesothelioma Model
Published on: October 2, 2015
Tsunami of immunotherapy reaches mesothelioma
Xabier Mielgo-Rubio1, Ana Cardeña Gutiérrez2, Verónica Sotelo Peña3
1Department of Medical Oncology, Hospital Universitario Fundación Alcorcón, Alcorcón 28922, Madrid, Spain. xmielgo@hotmail.com.
Abstract:
Malignant pleural mesothelioma (MPM) is the most common type of malignant mesothelioma. It is a rare tumor linked to asbestos exposure and is associated with a poor prognosis. Until very recently, patients with advanced or unresectable disease had limited treatment options, primarily based on doublet chemotherapy with cisplatin and pemetrexed. In 2020 and 2021, after more than a decade with no major advances or new drugs, two phase III clinical trials published results positioning immunotherapy as a promising option for the first- and second-line treatment of MPM. Immunotherapy has revolutionized the treatment of many cancers and is also showing encouraging results in malignant mesothelioma. Both immune checkpoint inhibition and dual cytotoxic T-lymphocyte-associated antigen 4 and programmed death-ligand 1 pathway blockade resulted in significantly improved overall survival in randomized phase III trials. In the CheckMate 743 trial, first-line therapy with nivolumab plus ipilimumab outperformed standard chemotherapy, while in the CONFIRM trial, nivolumab outperformed placebo in patients previously treated with chemotherapy. These two trials represent a major milestone in the treatment of MPM and are set to position immunotherapy as a viable alternative for treatment-naïve patients and patients with progressive disease after chemotherapy.
Insights
Immunotherapy offers a promising new treatment for malignant pleural mesothelioma (MPM), a rare asbestos-linked cancer. Recent trials show improved survival with immunotherapy, providing new options for advanced MPM patients.
Area of Science:
- Oncology
- Immunology
- Pulmonology
Background:
- Malignant pleural mesothelioma (MPM) is a rare, aggressive cancer linked to asbestos exposure.
- Patients with advanced or unresectable MPM historically had limited treatment options, primarily chemotherapy.
- Prognosis for MPM has been poor, with few therapeutic advances for over a decade.
Purpose of the Study:
- To evaluate the efficacy of novel immunotherapy treatments for malignant pleural mesothelioma.
- To assess immunotherapy as a first- and second-line treatment option for MPM.
- To determine if immunotherapy improves overall survival in advanced MPM patients.
Main Methods:
- Review of two randomized phase III clinical trials (CheckMate 743 and CONFIRM).
- Analysis of immunotherapy regimens including immune checkpoint inhibition and dual pathway blockade.
- Comparison of immunotherapy outcomes against standard chemotherapy and placebo.
Main Results:
- First-line immunotherapy (nivolumab plus ipilimumab) in CheckMate 743 demonstrated superior survival compared to chemotherapy.
- Second-line nivolumab in CONFIRM showed improved outcomes over placebo in previously treated patients.
- Both immune checkpoint inhibition and dual pathway blockade significantly improved overall survival.
Conclusions:
- Immunotherapy represents a significant advancement in MPM treatment, offering a viable alternative to chemotherapy.
- These findings position immunotherapy as a crucial option for both treatment-naïve and previously treated MPM patients.
- Further integration of immunotherapy is expected to change the treatment landscape for malignant pleural mesothelioma.
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