Menis Jessica, Pasello Giulia, Remon Jordi
Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.
Medical Oncology Department, Istituto Oncologico Veneto IRCCS, Padova, Italy.
Transl Lung Cancer Res. 2021 Jun;10(6):2988-3000. doi: 10.21037/tlcr-20-673.
Malignant pleural mesothelioma (MPM) is a rare, aggressive cancer of the pleural surface, associated with asbestos exposure, whose incidence is still growing in some areas of the world. MPM is still considered a rare and an orphan disease with an unchanged median overall survival (OS) ranging from 8 to 14 months and no treatment advances in the last 15 years both in local and advanced disease. In the recent years, chronic inflammation of the mesothelium together with local tumor suppression plays a major role in the malignant transformation. Also, significant heterogeneity in both tumor and the microenvironment is at the basis of MPM biology. Preclinical data have demonstrated the immunogenicity and the lack of an effective antitumor response by the immune system in MPM thus paving the way to the development of immune therapeutics in this disease. Still there is no clear evidence of any predictive biomarker so that, given the close interaction between the immune infiltrate and mesothelial cells, a number of trials are ongoing to investigate the role and prognostic value of the immune microenvironment. In this review we summarize the rationale for immune therapeutics development in MPM, as well as, the relevant literature and ongoing trials of immune checkpoint inhibitors (ICIs) and vaccines used as both first-line treatment and beyond.
恶性胸膜间皮瘤（MPM）是一种罕见的侵袭性胸膜表面癌症，与石棉暴露有关，其发病率在世界某些地区仍在上升。MPM仍被视为一种罕见的孤儿病，总体中位生存期（OS）在8至14个月之间且无变化，在过去15年中，无论是局部疾病还是晚期疾病，治疗都没有进展。近年来，间皮的慢性炎症以及局部肿瘤抑制在恶性转化中起主要作用。此外，肿瘤和微环境中的显著异质性是MPM生物学的基础。临床前数据已证明MPM具有免疫原性且免疫系统缺乏有效的抗肿瘤反应，从而为该疾病免疫治疗的发展铺平了道路。仍然没有任何预测生物标志物的明确证据，因此，鉴于免疫浸润与间皮细胞之间的密切相互作用，多项试验正在进行，以研究免疫微环境的作用和预后价值。在本综述中，我们总结了MPM免疫治疗发展的基本原理，以及免疫检查点抑制剂（ICI）和用作一线治疗及其他治疗的疫苗的相关文献和正在进行的试验。
