Checkpoint inhibitors in mesothelioma: hope for the future?
Mené en France sur 125 patients atteints d'un mésothéliome pleural malin, cet essai de phase II évalue l'efficacité, du point de vue du taux de contrôle de la maladie à 12 semaines, et la toxicité de l'ajout de l'ipilimumab au nivolumab, après l'échec d'une ou deux lignes de chimiothérapies à base de sels de platine et de pémétrexed
Malignant pleural mesothelioma is an aggressive, asbestos-related tumour of the thoracic cavity, with increasing global incidence. Prognosis is poor and treatment options are scarce. Pemetrexed and platinum doublet chemotherapy has been the standard first-line therapy for non-resectable malignant pleural mesothelioma since 2003, when a phase 3 randomised trial showed a survival benefit of 2·8 months compared with cisplatin alone. Treatment remained unchanged for more than a decade, until 2016, when the Mesothelioma Avastin plus Pemetrexed-cisplatin Study (MAPS) trial showed that adding the vascular endothelial growth factor antagonist, bevacizumab, to first-line chemotherapy extended survival to 18·8 months compared with 16·1 months with chemotherapy alone. Unfortunately, no second-line or third-line treatment has been established for relapsed or progressive malignant pleural mesothelioma, despite substantial academic endeavour.
The Lancet Oncology , commentaire, 2018