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Davis A, Ke H, Kao S, Pavlakis N. An Update on Emerging Therapeutic Options for Malignant Pleural Mesothelioma. LUNG CANCER (AUCKLAND, N.Z.) 2022; 13:1-12. [PMID: 35264891 PMCID: PMC8900635 DOI: 10.2147/lctt.s288535] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 02/10/2022] [Indexed: 12/11/2022]
Abstract
The treatment paradigm for malignant pleural mesothelioma (MPM) has changed little in the last 18 years. Radical intent treatment, consisting of surgical resection, radiotherapy and chemotherapy, has been offered to a highly select few; however, there is little randomised evidence to validate this approach. Prior to 2020 chemotherapy with platinum and an anti-folate was the only intervention with randomised evidence to demonstrate improved overall survival (OS) in MPM. No systemic therapy had been demonstrated to improve OS in the second line setting until 2020. The publication of the Checkmate 743 trial in 2021 demonstrated a survival benefit of combination immunotherapy over standard chemotherapy in newly diagnosed patients with MPM. This finding was shortly followed by the CONFIRM trial which demonstrates a modest but significant survival benefit of second line nivolumab versus placebo in patients having previously received standard chemotherapy. The results of these trials, recent biomarker directed therapy and chemotherapy adjuncts are discussed within this review. The integration of immunotherapy for the few patients in whom radical surgical therapy is intended is currently the subject of clinical trials and offers the prospect of improving outcomes in this rare but devastating disease.
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Affiliation(s)
- Alexander Davis
- Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia.,Department of Medical Oncology, Western Cancer Centre, Dubbo, NSW, Australia
| | - Helen Ke
- Asbestos Diseases Research Institute, Rhodes, NSW, Australia
| | - Steven Kao
- Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia.,Asbestos Diseases Research Institute, Rhodes, NSW, Australia.,School of Medicine, University of Sydney, Camperdown, NSW, Australia
| | - Nick Pavlakis
- School of Medicine, University of Sydney, Camperdown, NSW, Australia.,Department of Medical Oncology, Royal North Shore Hospital, St Leonards, NSW, Australia.,Department of Medical Oncology, Genesis Care, St Leonards, NSW, Australia
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Rijavec E, Biello F, Barletta G, Dellepiane C, Genova C. Novel approaches for the treatment of unresectable malignant pleural mesothelioma: A focus on immunotherapy and target therapy (Review). Mol Clin Oncol 2022; 16:89. [DOI: 10.3892/mco.2022.2522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 01/13/2022] [Indexed: 11/05/2022] Open
Affiliation(s)
- Erika Rijavec
- Medical Oncology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, I‑20122 Milan, Italy
| | - Federica Biello
- Department of Translational Medicine, Division of Oncology, University of Eastern Piemonte, I‑28100 Novara, Italy
| | - Giulia Barletta
- Medical Oncology Unit, IRCCS Ospedale Policlinico San Martino, I‑16132 Genoa, Italy
| | - Chiara Dellepiane
- Medical Oncology Unit, IRCCS Ospedale Policlinico San Martino, I‑16132 Genoa, Italy
| | - Carlo Genova
- Academic Oncology Unit, IRCCS Ospedale Policlinico San Martino, I‑16132 Genoa, Italy
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