Last week, a group of French researchers published a case study that will capture the attention of mesothelioma physicians and patients alike. Presented with inoperable malignant peritoneal mesothelioma in a 74-year-old patient, the team offered the dual immunotherapy protocol of nivolumab and ipilimumab as first-line therapy. The results were extremely encouraging.
Unresectable Malignant Peritoneal Mesothelioma Has a Poor Prognosis
Malignant peritoneal mesothelioma is a rare tumor with a poor prognosis. Though some patients are eligible for cytoreductive surgery with hyperthermic intraperitoneal chemotherapy, when tumors are either advanced or have so infiltrated the organs that they are unresectable, there are few options.Â
When a 74-year-old woman presented at Saint Quentin Hospital in Saint Quentin, France with malignant peritoneal mesothelioma, surgery was considered and rejected due to the disease being metastatic. Noting the expression of the PD-L1 protein that was evident from immunohistochemical staining, the team decided that the combination immunotherapy treatment offered the best hope for extended survival.
Immunotherapy Combination Yields Positive Outcome for Peritoneal Mesothelioma Patient
The mesothelioma patient received ten injections of nivolumab every three weeks and ipilimumab every six weeks as outlined in the Checkmate 743 trial. Her abdominal pain disappeared and performance status improved without significant toxicity, and subsequent CT scans showed a reduction in peritoneal infiltration. In May of 2023, her pain returned and a CT scan revealed new nodules in the peritoneum. Immunotherapy was discontinued and she began a regimen of pemetrexed, carboplatin, and bevacizumab.
The group reported that 24 months after her initial diagnosis, the patient remained well on pemetrexed and bevacizumab maintenance therapy. The group concluded that the major and sustained one-year response suggests a potential role for ICI in non-resectable diffuse malignant peritoneal mesothelioma, though they stress that further refinement of molecular classification of potential biomarkers is needed.
If you or someone you love has been diagnosed with mesothelioma, the new protocols and approaches being developed offer real hope. For information on the options and resources available to you, contact the Patient Advocates at Mesothelioma.net today at 1-800-692-8608.
