Targeting immunocheckpoint with immunomodulatory monoclonal antibodies has proven to be an effective antitumor strategy across a variety of cancers. The immunosuppressive tumor microenvironment in malignant pleural mesothelioma (MPM) has suggested that MPM might benefit from this kind of immunotherapy. In recent years, immunocheckpoint inhibitors (ICIs) have shown encouraging results for patients with MPM. Antibodies against programmed death 1 (PD-1) and PD-ligand 1 (PD-L1) have demonstrated favorable response, progression-free survival, and overall survival. The toxicity profiles were similar to those observed with ICIs in other malignancies, like melanoma and non-small cell lung cancer, and they appeared to be manageable. Nivolumab, an anti-PD-1 antibody, was approved in Japan for advanced or metastatic MPM patients resistant or intolerant to other chemotherapies. Important future issues include developing a combination therapy, where ICIs are combined with other agents (including other ICIs), and developing biomarkers for determining which patients might respond well and which might experience unacceptable toxicities.
Part of the book: Asbestos-related Diseases