A systematic review and meta-analysis of trials assessing PD-1/PD-L1 immune checkpoint inhibitors activity in pre-treated advanced stage malignant mesothelioma

Critical Reviews in Oncology/Hematology 2022 February 19 [Link]

Marco Tagliamento, Paolo Bironzo, Hubert Curcio, Emmanuele De Luca, Daniele Pignataro, Simonetta G Rapetti, Marco Audisio, Valentina Bertaglia, Chiara Paratore, Maristella Bungaro, Emanuela Olmetto, Elisa Artusio, Maria Lucia Reale, Clizia Zichi, Enrica Capelletto, Simona Carnio, Lucio Buffoni, Francesco Passiglia, Silvia Novello, Giorgio Vittorio Scagliotti, Massimo Di Maio


Introduction: Advanced stage malignant mesothelioma (asMM) patients have poor prognosis. Several trials investigated the role of programmed cell death protein-1 (PD-1) and its ligand 1 (PD-L1) immune checkpoint inhibitors (ICIs) in pre-treated asMM.

Methods: A systematic review of the literature of clinical trials testing single-agent anti PD-1/PD-L1 ICIs in pre-treated asMM was performed. Objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS) and overall survival (OS) data were extracted. The predictive role of PD-L1 was assessed.

Results: We selected 13 studies including 888 patients. ORR and DCR were 18.1% (95% confidence interval [CI] 13.9-22.8%) and 55.4% (95% CI: 48.1-62.5%), respectively. Median PFS and OS ranged from 2.1 to 5.9 and from 6.7 to 20.9 months, respectively. ORR according to PD-L1 was 27.0% (95% CI: 18.7-36.2%).

Conclusions: Anti-PD-(L)1 ICIs might be considered a treatment option for chemotherapy-resistant asMM, even if reliable predictive factors are still lacking.