Department of Internal Medicine and Medical Specialties (Di.M.I.), IRCCS Ospedale Policlinico San Martino, University of Genova, Largo Rosanna Benzi 10, 16132 Genova, Italy; Cancer Medicine Department, Institut Gustave Roussy, 114 Rue Edouard Vaillant, 94805 Villejuif, France.
Department of Oncology, AOU San Luigi Gonzaga, University of Torino, Regione Gonzole 10, 10043 Orbassano, Italy.
Crit Rev Oncol Hematol. 2022 Apr;172:103639. doi: 10.1016/j.critrevonc.2022.103639. Epub 2022 Feb 19.
Advanced stage malignant mesothelioma (asMM) patients have poor prognosis. Several trials investigated the role of programmed cell death protein-1 (PD-1) and its ligand 1 (PD-L1) immune checkpoint inhibitors (ICIs) in pre-treated asMM.
A systematic review of the literature of clinical trials testing single-agent anti PD-1/PD-L1 ICIs in pre-treated asMM was performed. Objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS) and overall survival (OS) data were extracted. The predictive role of PD-L1 was assessed.
We selected 13 studies including 888 patients. ORR and DCR were 18.1% (95% confidence interval [CI] 13.9-22.8%) and 55.4% (95% CI: 48.1-62.5%), respectively. Median PFS and OS ranged from 2.1 to 5.9 and from 6.7 to 20.9 months, respectively. ORR according to PD-L1 was 27.0% (95% CI: 18.7-36.2%).
Anti-PD-(L)1 ICIs might be considered a treatment option for chemotherapy-resistant asMM, even if reliable predictive factors are still lacking.
晚期恶性间皮瘤（asMM）患者预后较差。几项试验研究了程序性细胞死亡蛋白-1（PD-1）及其配体 1（PD-L1）免疫检查点抑制剂（ICI）在预处理 asMM 中的作用。
对临床试验中检测单药抗 PD-1/PD-L1 ICI 在预处理 asMM 中的应用进行了系统的文献复习。提取客观缓解率（ORR）、疾病控制率（DCR）、无进展生存期（PFS）和总生存期（OS）数据。评估 PD-L1 的预测作用。
我们选择了 13 项研究，共纳入 888 例患者。ORR 和 DCR 分别为 18.1%（95%CI：13.9-22.8%）和 55.4%（95%CI：48.1-62.5%）。中位 PFS 和 OS 分别为 2.1-5.9 和 6.7-20.9 个月。根据 PD-L1 表达水平，ORR 为 27.0%（95%CI：18.7-36.2%）。
抗 PD-（L）1 ICI 可考虑作为化疗耐药 asMM 的治疗选择，尽管仍缺乏可靠的预测因素。
