Salvage Pleurectomy/Decortication After Immunotherapy for Sarcomatoid Malignant Pleural Mesothelioma.

Sarcomatoid malignant pleural mesothelioma (MPM) is a highly aggressive malignant tumor. Surgery may not be recommended, and chemotherapy is less effective. More recently, immunotherapy has become a new standard treatment of care for advanced MPM across all histologic subtypes. This reports describes a case of salvage lung-sparing surgery (pleurectomy with decortication) after immunotherapy with nivolumab in combination with ipilimumab for sarcomatoid MPM. The surgical specimen showed that a major pathologic response was achieved with immunotherapy. The present case indicates not only the feasibility of pleurectomy with decortication after immunotherapy but also pathologic evidence of the efficacy of immunotherapy, which provides insight into the treatment of advanced MPM.