1903P - Immunotherapy for malignant pleural mesothelioma: A French retrospective real-life study

Background

Immunotherapy (IO) by checkpoint blockers is a new option in the treatment of malignant pleural mesothelioma (MPM). In the 2^nd or 3^rd line setting, the prospective MAPS 2 study found median progression free survival (PFS) and overall survival (OS) of 4 [2.8- 5.7] and 11.9 [6.7-17.7] months in nivolumab group and 5.6 [ 3.1-8.3] and 15.9 [10.7- NR] months in the nivolumab + ipilimumab group, respectively. The objective of this study is to evaluate the efficacy and safety of IO, in MPM in 2nd line or beyond in a real-life setting.

Methods

Multi-center retrospective study including MPM patients treated with IO in a real-life setting, between November 2017 and April 2020 assessing efficacy (disease response, PFS and OS) and tolerance.

Results

The analysis involved 33 patients (Males 79%, median age 70 years, PS 0 (27%) or 1 (73%), epithelioid 81%, BAP1 loss 24%, albumin 36 [33-40] g/L, blood LDH 224 [213; 290] U/L, PNN 5 [4.1-6.1] G/L, Hb 12,3 [11.4-13.7] g/dL); Before IO, patients had a median of 2 lines of treatments (IO administrated as first, 2^nd, 3^rd or 4^th lines in 1,14,16 and 2 cases respectively). Before IO, 78% received platinum plus pemetrexed chemotherapy ±bevacizumab in 16% extra cases. The median duration of Nivolumab was 3 [1-5] months. With median follow-up of 12 months, PFS and OS were 4 [1-6] and 6 [4-11.5] months, respectively; disease control rate was 57% (5 partial responses and 14 stable disease); 42% had adverse events (AE) of any grade: cutaneous (43%), pulmonary (21%) and digestive (21%), mostly grade 2 (71%). There were 2 grade 3 (cutaneous and rheumatologic) AE inducing Nivolumab stop. Finally, 15/27 (56%) patients had post-IO chemotherapy (mainly gemcitabine).

Conclusions

Despite modest results compared to MAPS2 trial, which can be explained by more 3^rd line or beyond patients in this series, nivolumab seems a clinically meaningful option for some patients in routine. Ancillary studies are ongoing to better select the best candidates for IO.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

A.B. Cortot: Advisory/Consultancy, Travel/Accommodation/Expenses: BMS. C. Chouaid: Advisory/Consultancy, Research grant/Funding (institution): Roche; Advisory/Consultancy: Lilly; Advisory/Consultancy: Pfizer; Advisory/Consultancy, Research grant/Funding (institution): Boehringer Ingelheim; Advisory/Consultancy: Clovis Oncology; Advisory/Consultancy, Research grant/Funding (institution): MSD; Advisory/Consultancy, Research grant/Funding (institution): Bristol-Myers-Squibb; Advisory/Consultancy: Novartis; Advisory/Consultancy: Pierre Fabre; Advisory/Consultancy, Research grant/Funding (institution): AstraZeneca; Advisory/Consultancy, Research grant/Funding (institution): Takeda; Advisory/Consultancy: Janssen; Advisory/Consultancy: Bayer; Research grant/Funding (institution): Chugai. A. Scherpereel: Honoraria (self), Non-remunerated activity/ies: Bristol-Myers Squibb; Honoraria (self), Non-remunerated activity/ies: Roche; Honoraria (self), Non-remunerated activity/ies: Merck Sharp & Dohme. All other authors have declared no conflicts of interest.