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Tagliamento M, Di Maio M, Remon J, Bironzo P, Genova C, Facchinetti F, Aldea M, Le Péchoux C, Novello S, Barlesi F, Besse B, Planchard D. Meta-Analysis on the Combination of Chemotherapy With Programmed Death-Ligand 1 and Programmed Cell Death Protein 1 Blockade as First-Line Treatment for Unresectable Pleural Mesothelioma. J Thorac Oncol 2024; 19:166-172. [PMID: 37567387 DOI: 10.1016/j.jtho.2023.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 07/11/2023] [Accepted: 08/01/2023] [Indexed: 08/13/2023]
Abstract
INTRODUCTION Dual immune checkpoint blockers regimen represents a standard first-line therapy in unresectable pleural mesothelioma (PM). Novel combination strategies, including immune checkpoint blockers and antiangiogenic drugs, are currently under investigation in this setting. We aimed to assess the efficacy of the chemoimmunotherapy combination by reference to literature evidence. METHODS A systematic review and meta-analysis of trials with first-line platinum-based chemotherapy associated with programmed death-ligand 1 and programmed cell death protein 1 agent in unresectable PM. We estimated the weighted summary proportion of disease response, along with the landmark probability of survival outcomes. RESULTS A total of 349 patients with unresectable PM from four trials (DREAM, PrE0505, JME-001, and IND.227) were included, 79% (n = 274) with epithelioid and 21% (n = 75) with nonepithelioid histologic type. In aggregate, the objective response rate was 59.2% (95% confidence interval [CI]: 50.3%-67.9%) and disease control rate was 92.2% (95% CI: 89.2%-94.8%). Comparing epithelioid versus nonepithelioid tumors, the objective response rate was 64.5% versus 46.4%, (p < 0.001) and the disease control rate was 92.3% versus 80.0%, (p = 0.043), with an OR of 2.56 (95% CI: 1.51-4.32) for disease response and of 3.37 (95% CI: 0.99-11.47) for disease control. The aggregated estimated probability of progression-free survival was 63% (95% CI: 53%-71%) at 6 months and 25% (95% CI: 21%-31%) at 12 months, whereas the 6-, 12- and 24-month overall survival rates were 88% (95% CI: 81%-93%), 71% (95% CI: 61%-79%) and 39% (95% CI: 34%-45%), respectively. CONCLUSIONS According to our analysis, first-line chemoimmunotherapy holds promise as a new treatment approach for PM, exhibiting encouraging survival outcomes and an enhanced response rate, including for the epithelioid subtype. Ongoing studies are necessary to establish its precise placement within the treatment algorithm.
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Affiliation(s)
- Marco Tagliamento
- Department of Cancer Medicine, Gustave Roussy, Villejuif, France; Department of Internal Medicine and Medical Specialties, University of Genova, Genova, Italy
| | - Massimo Di Maio
- Medical Oncology, Ordine Mauriziano Hospital, Turin, Italy; Department of Oncology, University of Turin, Turin, Italy
| | - Jordi Remon
- Department of Cancer Medicine, Gustave Roussy, Villejuif, France
| | - Paolo Bironzo
- Department of Oncology, University of Turin, Turin, Italy; Thoracic Oncology, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - Carlo Genova
- Department of Internal Medicine and Medical Specialties, University of Genova, Genova, Italy; UO Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Francesco Facchinetti
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Mihaela Aldea
- Department of Cancer Medicine, Gustave Roussy, Villejuif, France; School of Medicine, Paris-Saclay University, Kremlin-Bicêtre, France
| | | | - Silvia Novello
- Department of Oncology, University of Turin, Turin, Italy; Thoracic Oncology, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - Fabrice Barlesi
- Department of Cancer Medicine, Gustave Roussy, Villejuif, France; School of Medicine, Paris-Saclay University, Kremlin-Bicêtre, France
| | - Benjamin Besse
- Department of Cancer Medicine, Gustave Roussy, Villejuif, France; School of Medicine, Paris-Saclay University, Kremlin-Bicêtre, France
| | - David Planchard
- Department of Cancer Medicine, Gustave Roussy, Villejuif, France; School of Medicine, Paris-Saclay University, Kremlin-Bicêtre, France.
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Mansfield AS. Maintaining Equipoise With Maintenance Therapy in Mesothelioma. Clin Lung Cancer 2020; 21:482-484. [PMID: 32782159 DOI: 10.1016/j.cllc.2020.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 07/13/2020] [Accepted: 07/14/2020] [Indexed: 11/20/2022]
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Gill RR, Tsao AS, Kindler HL, Richards WG, Armato SG, Francis RJ, Gomez DR, Dahlberg S, Rimner A, Simone CB, de Perrot M, Blumenthal G, Adjei AA, Bueno R, Harpole DH, Hesdorffer M, Hirsch FR, Pass HI, Yorke E, Rosenzweig K, Burt B, Fennell DA, Lindwasser W, Malik S, Peikert T, Mansfield AS, Salgia R, Yang H, Rusch VW, Nowak AK. Radiologic Considerations and Standardization of Malignant Pleural Mesothelioma Imaging Within Clinical Trials: Consensus Statement from the NCI Thoracic Malignancy Steering Committee - International Association for the Study of Lung Cancer - Mesothelioma Applied Research Foundation Clinical Trials Planning Meeting. J Thorac Oncol 2019; 14:1718-1731. [PMID: 31470129 DOI: 10.1016/j.jtho.2019.08.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 06/26/2019] [Accepted: 08/20/2019] [Indexed: 12/19/2022]
Abstract
Detailed guidelines pertaining to radiological assessment of malignant pleural mesothelioma are currently lacking due to the rarity of the disease, complex morphology, propensity to invade multiple planes simultaneously, and lack of specific recommendations within the radiology community about assessment, reporting, and follow-up. In March 2017, a multidisciplinary meeting of mesothelioma experts was co-sponsored by the National Cancer Institute Thoracic Malignancy Steering Committee, International Association for the Study of Lung Cancer, and the Mesothelioma Applied Research Foundation. One of the outcomes of this conference was the foundation of detailed, multidisciplinary consensus imaging and management guidelines. Here, we present the recommendations for radiologic assessment of malignant pleural mesothelioma in the setting of clinical trial enrollment. We discuss optimization of imaging parameters across modalities, standardized reporting, and response assessment within clinical trials.
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Affiliation(s)
- Ritu R Gill
- Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
| | - Anne S Tsao
- Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Hedy L Kindler
- Section of Hematology/Oncology, University of Chicago Medical Center, Chicago, Illinois
| | - William G Richards
- Department of Surgery, Brigham & Women's Hospital, Boston, Massachusetts
| | - Samuel G Armato
- Department of Radiology, University of Chicago, Chicago, Illinois
| | - Roslyn J Francis
- Department of Nuclear Medicine, Sir Charles Gairdner Hospital and Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia
| | - Daniel R Gomez
- Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas; Departments of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York; Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Suzanne Dahlberg
- Department of Biostatistics, Dana Farber Cancer Institute, Boston, Massachusetts
| | - Andreas Rimner
- Departments of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York; Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas; Departments of Radiation Oncology, Surgery, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Charles B Simone
- Department of Radiation Oncology, New York Proton Center, New York, New York
| | - Marc de Perrot
- Cancer Clinical Research Unit, Princess Margaret Cancer Center, Toronto, Ontario, Canada
| | - Gideon Blumenthal
- U.S. Food and Drug Administration, National Cancer Institute, Bethesda, Maryland
| | - Alex A Adjei
- Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota
| | - Raphael Bueno
- Department of Surgery, Brigham & Women's Hospital, Boston, Massachusetts
| | - David H Harpole
- Department of Surgery, Duke University School of Medicine, Durham, North Carolina
| | | | - Fred R Hirsch
- Center for Thoracic Oncology, Mount Sinai Cancer, Mount Sinai Health System, New York, New York
| | - Harvey I Pass
- Department of Cardiothoracic Surgery, NYU School of Medicine, New York, New York
| | - Ellen Yorke
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kenneth Rosenzweig
- Department of Radiation Oncology, Mount Sinai School of Medicine, New York, New York
| | - Bryan Burt
- Department of Thoracic Surgery, Baylor College of Medicine, Houston, Texas
| | - Dean A Fennell
- Leicester Cancer Research Centre, University of Leicester, Leicester, United Kingdom
| | | | | | - Tobias Peikert
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota
| | - Aaron S Mansfield
- U.S. Food and Drug Administration, National Cancer Institute, Bethesda, Maryland
| | - Ravi Salgia
- Department of Medical Oncology & Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Haining Yang
- Department of Pathology, University of Hawaii, Honolulu, Hawaii
| | - Valerie W Rusch
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Anna K Nowak
- Department of Medicine, Sir Charles Gairdner Hospital and Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia
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Tsao MS, Carbone M, Galateau-Salle F, Moreira AL, Nicholson AG, Roden AC, Adjei AA, Aubry MC, Fennell DA, Gomez D, Harpole D, Hesdorffer M, Hirsch FR, Liu G, Malik S, Nowak A, Peikert T, Salgia R, Szlosarek P, Taioli E, Yang H, Tsao A, Mansfield AS. Pathologic Considerations and Standardization in Mesothelioma Clinical Trials. J Thorac Oncol 2019; 14:1704-1717. [PMID: 31260832 DOI: 10.1016/j.jtho.2019.06.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 06/20/2019] [Accepted: 06/20/2019] [Indexed: 02/06/2023]
Abstract
The accurate diagnosis of mesothelioma is critical for the appropriate clinical management of this cancer. Many issues complicate making the diagnosis of mesothelioma including the presence of reactive mesothelial cells in benign pleural effusions, the heterogeneity of mesothelioma histopathology, the relatively high incidence of other epithelial malignancies that metastasize to the pleura, and primary sarcomas that arise within the pleura. Given the rapidly evolving field of molecular profiling and the need for translational correlates in mesothelioma clinical trials, the National Cancer Institute (NCI)-International Association for the Study of Lung Cancer-Mesothelioma Applied Research Foundation Clinical Trials Planning Meeting was convened in March 2017 to develop a consensus on standard pathology guidelines for future NCI-sponsored clinical trials in mesothelioma. This consensus statement covers recommendations for specimen handling, pathologic classification and diagnosis, biobanking, and tissue correlative studies.
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Affiliation(s)
- Ming-Sound Tsao
- Department of Pathology, Princess Margaret Cancer Centre and University of Toronto, Toronto, Ontario, Canada
| | - Michele Carbone
- Thoracic Oncology Program, University of Hawaii Cancer Center, Honolulu, Hawaii
| | | | - Andre L Moreira
- Department of Pathology, New York University Langone Health, New York, New York
| | - Andrew G Nicholson
- Department of Histopathology, Royal Brompton and Harefield NHS Foundation Trust and National Heart and Lung Institute, Imperial College, London, United Kingdom
| | - Anja C Roden
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Alex A Adjei
- Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota
| | | | - Dean A Fennell
- Mesothelioma Research Programme, Leicester Cancer Research Centre, Leicester, United Kingdom
| | - Daniel Gomez
- Department of Radiation Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - David Harpole
- Division of Cardiothoracic Surgery, Department of Surgery, Duke University, Durham, North Carolina
| | - Mary Hesdorffer
- Mesothelioma Applied Research Foundation, Alexandria, Virginia
| | - Fred R Hirsch
- Mount Sinai Health System, Center for Thoracic Oncology/Tisch Cancer Center, New York, New York
| | - Geoffrey Liu
- Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Shakun Malik
- Clinical Investigations Branch, Cancer Therapy Evaluation Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Anna Nowak
- National Centre for Asbestos Related Disease, University of Western Australia, Nedlands, Western Australia, Australia
| | - Tobias Peikert
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota
| | - Ravi Salgia
- Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, California
| | - Peter Szlosarek
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Emanuela Taioli
- Department of Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Haining Yang
- Thoracic Oncology Program, University of Hawaii Cancer Center, Honolulu, Hawaii
| | - Anne Tsao
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
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