The randomized phase III CheckMate 743 trial breaks new ground in malignant pleural mesothelioma (MPM) by establishing the benefit of a chemotherapy-free regimen in patients with previously untreated disease. Data from a prespecified interim analysis, based on a minimum follow-up of 22 months, showed that combined treatment with nivolumab and ipilimumab yielded a 4-month improvement in median overall survival (OS) as compared with platinum doublet chemotherapy (18.1 vs 14.1 months; hazard ratio [HR] 0.74, 95% CI 0.60-0.91; P = 0.0020). At 24 months, 41% of patients treated with the dual-immunotherapy regimen remained alive as compared with 27% of patients treated with chemotherapy.
To put these findings into context, median OS for previously untreated patients with advanced or metastatic MSM typically reaches about 15 months at best, and less than 10% of patients survive to 5 years,1 underscoring the aggressive nature of this rare disease.
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