Multinational phase 3 trial of chemotherapy with or without pembrolizumab for untreated advanced pleural mesothelioma

Pleural mesothelioma usually presents at an advanced, incurable stage. Platinum-pemetrexed is a standard treatment. A phase 3 trial at 51 centers in Canada, France, and Italy evaluated addition of pembrolizumab to first-line platinum-pemetrexed chemotherapy for advanced pleural mesothelioma. The median overall survival was 17.3 months with pembrolizumab-chemotherapy versus 16.1 months with chemotherapy alone (HR 0.79; p=0.0324). Grade 3 or 4 treatment-related adverse events occurred in 27% versus 15%, and grade 5 TRAEs in two versus one patients. The authors conclude that among patients with untreated advanced pleural mesothelioma, the addition of pembrolizumab to standard platinum-pemetrexed chemotherapy was tolerable and resulted in significant improvement in overall survival.