Immune checkpoint inhibition for the treatment of mesothelioma. (3rd July 2019)

• Record Type: Journal Article
• Authors: Nowak, Anna K; McDonnell, Alison; Cook, Alistair
• Is Part Of: Expert opinion on biological therapy. Volume 19:Number 7(2019)
• Page Start: 697
• Page End: 706
• Publication Date: 2019-07-03
• Subjects: Antineoplastic therapy -- biomarkers -- checkpoint blockade -- immunotherapy -- mesothelioma; Gene therapy -- Periodicals; Protein drugs -- Periodicals; Peptide drugs -- Periodicals; Immunotherapy -- Periodicals; Drug delivery systems -- Periodicals; 615.5
• DOI: 10.1080/14712598.2019.1606209
• Languages: English
• ISSNs: 1471-2598

Abstract

ABSTRACT: Introduction: Combination chemotherapy is currently standard care for advanced mesothelioma. Checkpoint blockade is a promising new treatment. Areas covered: This review covers clinical use and biomarkers of checkpoint blockade. Medline search used keywords 'mesothelioma' combined with 'checkpoint blockade' OR 'PD-L1ʹ OR 'PD1ʹ OR 'anti-CTLA4ʹ; the search terms AND 'clinical trial' or AND 'biomarker*' were added. Handsearching covered abstracts from relevant meetings from 2016 to 2018 and reference lists. Data informed a narrative review. Expert Opinion: Single agent anti-CTLA4 blockade is inactive in mesothelioma. Single agent PD-1 blockade as second or subsequent treatment gives 20–29% partial responses; no randomized comparisons against placebo or chemotherapy are available. Biomarkers of response have been difficult to identify. There is no consensus as to whether tumor PD-L1 expression predicts outcomes. Combination checkpoint inhibitors (CTLA4 and PD1 blockade) provide a small incremental increase in response rates and progression-free survival. Chemoimmunotherapy is the next frontier.