Chevallier Mathieu, Kim Floryane, Friedlaender Alex, Addeo Alfredo
Department of Oncology, University Hospital Geneva, Geneva, Switzerland.
Clinique General Beaulieu, Geneva, Switzerland.
Clin Med Insights Oncol. 2023 Jul 20;17:11795549231178173. doi: 10.1177/11795549231178173. eCollection 2023.
Over the course of the last decade, immunotherapy has revolutionised the management of a great number of cancer types. The treatment of pleural mesothelioma, a rare and highly aggressive cancer, is also being transformed by immunotherapy. The recent combination of ipilimumab and nivolumab improved overall survival compared with platinum-based chemotherapy, irrespective of the histology, establishing immunotherapy as a front-line standard of care in advanced pleural mesothelioma. Yet, most patients do not derive long-term benefit from any of the available therapies, and we note a significant lack of predictive and prognostic biomarkers. After progressing on first-line therapy, patients have limited therapeutic options, and data are scarce about optimal sequencing. In this perspective, we discuss the current management of pleural mesothelioma, defining what we consider to be the therapeutic sequence based on performance status and tumour histology. We also highlight promising ongoing trials that could further shape the management of this rare disease.
在过去十年间，免疫疗法彻底改变了多种癌症的治疗方式。免疫疗法也正在改变罕见且侵袭性很强的癌症——胸膜间皮瘤的治疗方法。与基于铂类的化疗相比，最近伊匹单抗和纳武单抗联合使用提高了总生存率，无论组织学类型如何，这确立了免疫疗法作为晚期胸膜间皮瘤一线标准治疗方案的地位。然而，大多数患者无法从任何现有疗法中获得长期益处，而且我们注意到预测性和预后生物标志物严重缺乏。一线治疗进展后，患者的治疗选择有限，关于最佳治疗顺序的数据也很少。从这个角度出发，我们讨论了胸膜间皮瘤的当前治疗方法，根据身体状况和肿瘤组织学确定了我们认为的治疗顺序。我们还强调了一些有前景的正在进行的试验，这些试验可能会进一步塑造这种罕见疾病的治疗方式。
