CONFIRMing single-drug immune checkpoint blockade efficacy in mesothelioma
Mené au Royaume-Uni sur 221 patients atteints d'un mésothéliome récidivant, cet essai de phase III évalue l'efficacité, du point de vue de la survie sans progression et de la survie globale, et la toxicité du nivolumab, après l'échec d'une chimiothérapie de première ligne à base de sels de platine (durée médiane de suivi : 11,6 mois)
Mesothelioma is an uncommon cancer, but, despite a reduction in asbestos use in high-incomecountries in the past few decades, we are still facing a global epidemic of this disease.Immune checkpoint blockade had an inauspicious start in mesothelioma, when the anti-CTLA-4antibody, tremelimumab, was shown to not improve overall survival compared with placeboin the second-line setting. However, outcomes from several subsequent single-arm clinical trials suggested anti-tumouractivity of PD-1 or PD-L1 blockade in patients with mesothelioma. Objective tumour response rates ranged from 20–30%. Together with promising progression-freesurvival and overall survival outcomes, these trials triggered inclusion of singledrug PD-1 inhibition as an option for subsequent-line therapy in some—but not all—clinicalpractice guidelines from as early as 2017.
The Lancet Oncology , commentaire, 2020