Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Current State of Art Therapy for MPM and Future Options Focus on Immunotherapy

Susana Cedres
* ORCID logo ,
Augusto Valdivia
,
Patricia Iranzo
,
Ana Callejo
,
Nuria Pardo
,
Alejandro Navarro
,
Alex Martinez-Marti
,
Juan David Assaf-Pastrana
,
Enriqueta Felip
,
Pilar Garrido
Version 1 : Received: 17 November 2023 / Approved: 17 November 2023 / Online: 17 November 2023 (14:27:32 CET)

A peer-reviewed article of this Preprint also exists.

Cedres, S.; Valdivia, A.; Iranzo, P.; Callejo, A.; Pardo, N.; Navarro, A.; Martinez-Marti, A.; Assaf-Pastrana, J.D.; Felip, E.; Garrido, P. Current State-of-the-Art Therapy for Malignant Pleural Mesothelioma and Future Options Centered on Immunotherapy. Cancers 2023, 15, 5787. Cedres, S.; Valdivia, A.; Iranzo, P.; Callejo, A.; Pardo, N.; Navarro, A.; Martinez-Marti, A.; Assaf-Pastrana, J.D.; Felip, E.; Garrido, P. Current State-of-the-Art Therapy for Malignant Pleural Mesothelioma and Future Options Centered on Immunotherapy. Cancers 2023, 15, 5787.

Abstract

Malignant pleural mesothelioma (MPM) is a locally aggressive disease related to asbestos exposure with a median survival for untreated patients of 4-8 months. The combination of chemotherapy based in platinum and antifolate is the standard treatment and the addition of bevacizumab adds two months of gain in median survival. Recently in first-line treatment, immunotherapy combining nivolumab with ipilimumab has been shown to be superior to chemotherapy in the CheckMate-743 study in terms of overall survival (18.1 months), leading to its approval by the FDA and EMA. The positive results of this study represent a new standard of treatment for patients with MPM, however, not all patients will benefit from immunotherapy treatment. In an effort to improve the selection of patient candidates for immunotherapy in different tumors, biomarkers that have been associated with a greater possibility of response to treatment have been described. MPM is a type of tumor with low mutational load and neo-antigens, making it a relatively non-immunogenic tumor for T cells and possibly less susceptible to responding to immunotherapy. Different retrospective studies have shown that PD-L1 expression occurs in 20-40% of patients and is associated with a poor prognosis; however, the predictive value of PD-L1 in response to immunotherapy has not been confirmed. The purpose of this work is to review state of art of MPM treatment in the year 2023 focusing in the efficacy results of first-line or subsequent immunotherapy studies in patients with MPM and possible chemo-immunotherapy combination strategies. Additionally, potential biomarkers of response to immunotherapy will be reviewed, such as histology, PD-L1, lymphocyte populations, and TMB.

Keywords

malignant pleural mesothelioma; immunotherapy; biomarkers

Subject

Medicine and Pharmacology, Oncology and Oncogenics

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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