Pembrolizumab as Palliative Immunotherapy in Malignant Pleural Mesothelioma.

Détails

ID Serval
serval:BIB_2C36AC8D11B9
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Pembrolizumab as Palliative Immunotherapy in Malignant Pleural Mesothelioma.
Périodique
Journal of thoracic oncology
Auteur(s)
Metaxas Y., Rivalland G., Mauti L.A., Klingbiel D., Kao S., Schmid S., Nowak A.K., Gautschi O., Bartnick T., Hughes B.G., Bouchaab H., Rothschild S.I., Pavlakis N., Wolleb S., Petrausch U., O'Byrne K., Froesch P., Löffler-Baumann M., Pratsch-Peter S., Russell P., Savic S., Mingrone W., Thapa B., Früh M., Pless M., von Moos R., John T.
ISSN
1556-1380 (Electronic)
ISSN-L
1556-0864
Statut éditorial
Publié
Date de publication
11/2018
Peer-reviewed
Oui
Volume
13
Numéro
11
Pages
1784-1791
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
There is no approved second-line treatment for malignant pleural mesothelioma (MPM). On the basis of promising early results, pembrolizumab was used off-label in Switzerland and Australia. We investigated outcomes in association with clinicopathological features and expression of programmed death ligand 1 (PD-L1).
Registry data in Australia and Switzerland were pooled. Patient characteristics, including age, sex, histological subtype, and previous treatments were captured. Outcomes were assessed locally. PD-L1 expression was categorized as negative (<5%), intermediate (5%-49%), and high (≥50%).
A total of 93 patients (48 from Switzerland and 45 from Australia) were treated; 68 patients (73%) had epithelioid MPM, and 67 (72%) had an Eastern Cooperative Oncology Group performance status of 0 or 1. Pembrolizumab was the second-line treatment in 48 of 93 patients (52%). PD-L1 expression results were available for 66 patients (71%). Most (68%) were negative, 18% were intermediate, and 14% were high for PD-L1 expression. In the full cohort, the overall response rate (ORR) was 18%, the median progression-free survival (mPFS) was 3.1 months, and the median overall survival was 7.2 months. In patients with an Eastern Cooperative Oncology Group performance status of 0 or 1 and only one previous systemic treatment (n = 35), the ORR was 37%, the mPFS was 3.7 months, and the median overall survival was 10.2 months. The nonepitheloid histological subtype showed an improved ORR (24% versus 16% [p = 0.54) and mPFS (5.6 versus 2.8 months [p = 0.02]). Compared with intermediate and negative PD-L1 expression, high PD-L1 expression was associated with an improved ORR (44% versus 42% versus 11% [p = 0.01]) and mPFS (6.2 versus 3.9 versus 2.7 months [p = 0.04]). Toxicity was as expected.
These real-world data demonstrate similar response rates but inferior survival compared with those in early-phase trials. High PD-L1 expression and nonepitheloid histological subtype were associated with greater activity. Anti-PD-L1 immunotherapy is a reasonable second-line therapy in patients with MPM.
Mots-clé
Adult, Aged, Aged, 80 and over, Antibodies, Monoclonal, Humanized/therapeutic use, Antineoplastic Agents, Immunological/therapeutic use, Female, Humans, Immunotherapy/methods, Lung Neoplasms/drug therapy, Lung Neoplasms/immunology, Lung Neoplasms/pathology, Male, Mesothelioma/drug therapy, Mesothelioma/immunology, Mesothelioma/pathology, Middle Aged, Pleural Neoplasms/drug therapy, Pleural Neoplasms/immunology, Pleural Neoplasms/pathology, Immunotherapy, Mesothelioma, PD-1, Pembrolizumab, Second-line therapy
Pubmed
Web of science
Création de la notice
03/09/2018 14:58
Dernière modification de la notice
03/10/2019 5:09
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