2191P - Real-world outcomes of patients with malignant pleural mesothelioma (MPM) treated with combination nivolumab and ipilimumab in the first- or later line setting

Background

Based on the positive results of the CheckMate-743 trial, first-line (1L) treatment of MPM with ipilimumab in combination with nivolumab (ipi/nivo) has become a standard 1L treatment in patients (pts) with non-epithelioid MPM and epithelioid MPM. Pts who received 1L platinum-pemetrexed are often considered for further-line treatment with ipi/nivo based on the MAPS2 trial results. Here we report on real-world survival outcomes and toxicity with ipi/nivo for treatment of MPM in Switzerland.

Methods

This was a retrospective multicenter analysis in 12 Swiss centers including all pts treated with ipi/nivo for MPM; data cut-off was on May 1, 2023. Pts’ characteristics including age, sex, histology, PD-L1, ECOG and previous/subsequent treatments were collected. Efficacy and safety outcomes were assessed by local investigators.

Results

Of 109 patients with MPM (75% epithelioid, 9% biphasic, 16% sarcomatoid) treated with ipi/nivo (start of treatment November 2017-March 2023) median age was 72 years, 91% were males, and 83% had ECOG 0-1 at start of ipi/nivo. Ipi/nivo was given as 1L treatment in 43%, as 2L or further line in 57% of pts. 2 year-completion rate of ipi/nivo was 0%; treatment is ongoing in 16 pts (15%). Median follow-up from start of ipi/nivo was 16.6 months (mo). Efficacy outcomes for ipi/nivo are shown in the table. Highest-grade adverse events (AE) were as follows: 14% G1, 22% G2, 21% G3, 2% G4 and 3% G5 (1 colitis, 2 pneumonitis). Treatment discontinuation rate due to toxicity was 19%.

Table: 2191P

Outcomes

Conclusions

In this real-world cohort of MPM pts treated with ipi/nivo efficacy outcomes were inferior to those reported in the CM743 and MAPS2 trials, while safety outcomes were similar. Subgroup analyses by histology, PD-L1 expression, age and ECOG will be presented at the meeting.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

S. Schmid: Financial Interests, Institutional, Advisory Board: AstraZeneca, MSD, BMS, Merck; Financial Interests, Institutional, Funding: Janssen, BMS, AstraZeneca; Financial Interests, Personal, Other, Congress travel support: Takeda, MSD, Amgen; Financial Interests, Institutional, Speaker, Consultant, Advisor: MSD. M. Frueh: Financial Interests, Institutional, Advisory Board: BMS, AstraZeneca, MSD, Takeda, Roche, Lilly, Boehringer Ingelheim, Novartis, Amgen; Financial Interests, Institutional, Funding: BMS. K. Koster: Financial Interests, Institutional, Other, Travel support: Takeda, Janssen. S.I. Rothschild: Financial Interests, Institutional, Other, Honoraria: Roche, AstraZeneca, BMS, Boehringer Ingelheim, MSD, Novartis, Amgen, Lilly, Eisai, Merck. Pfizer, Takeda, Bayer, Janssen, Otsuka, PharmaMar, Sanofi; Financial Interests, Institutional, Advisory Board: AstraZeneca, Boehringer Ingelheim, BMS, Pfizer, Eisai, Lilly, Merck, MSD, Novartis, Roche, Takeda, Amgen, Otsuka, PharaMar; Financial Interests, Institutional, Other, Speakers Bureau: Roche, Sanofi/Aventis, Amgen, AstraZeneca, Takeda; Financial Interests, Institutional, Funding: AbbVie, BMS, AstraZeneca, Boehringer Ingelheim, Merck, Roche; Financial Interests, Institutional, Other, Travel support etc: Sanofi, Roche, BMS, MSD, AstraZeneca, Takeda, Boehringer Ingelheim, Amgen; Financial Interests, Personal, Other: Federal Drug Commission of the Federal Office of public Health; Financial Interests, Institutional, Other: SAKK. C. Britschgi: Financial Interests, Personal, Advisory Board: AstraZeneca, Pfizer, Roche, Takeda, Janssen, Boehringer Ingelheim, Roche, Merck, Sanofi; Financial Interests, Personal, Other, Travel support: AstraZeneca, Takeda, Amgen. M.T. Mark: Financial Interests, Institutional, Advisory Board: AstraZeneca, Merck, MSD, Sanofi, BMS, Roche, Takeda; Financial Interests, Personal, Other, Travel grants: Takeda, Sanofi, Roche; Financial Interests, Institutional, Funding: Gilead, Swiss Cancer Foundation. P.R. Froesch: Financial Interests, Institutional, Advisory Board: Roche, Takeda, Janssen, Pfizer, Novartis, Lilly, Sanofi. W. Janthur: Financial Interests, Personal, Advisory Board: Astra, Roche, Pfizer, BI, MSD, Takeda; Financial Interests, Personal, Other, Travel Grant: Astra, Roche. A.T. Allemann: Financial Interests, Institutional, Advisory Board: Janssen; Financial Interests, Personal, Other, Travel support: Janssen; Financial Interests, Institutional, Speaker, Consultant, Advisor: Janssen, AstraZeneca. F.W.F. Cerciello: Financial Interests, Institutional, Advisory Board: BMS, PharmaMar. L.A. Mauti: Financial Interests, Personal, Other, Honoraria: Takeda, Amgen, MSD, Astra; Financial Interests, Personal, Advisory Board: MSD, BMS, Astra, Merck, Roche, Pfizer, Novartis, Sanofi, Takeda; Financial Interests, Institutional, Funding: AstraZeneca; Financial Interests, Personal, Expert Testimony: MSD, Merck; Financial Interests, Personal, Other, Travel support: Roche, Sanofi, Takeda, Astra. All other authors have declared no conflicts of interest.