Single-center phase 2 trial of second- or third-line pembrolizumab plus lenvantib for pleural mesothelioma

The combination of the anti-PD-1 antibody pembrolizumab and the antiangiogenic multikinase inhibitor lenvatinib shows synergistic activity for solid tumors. The phase 2 PEMMELA trial, at the Netherlands Cancer Institute (Amsterdam), evaluated this combination as second-line or third-line option for patients with pleural mesothelioma after progression on platinum-pemetrexed chemotherapy. Objective response was seen in 58% of patients. Serious treatment-related adverse events occurred in 26%, including one treatment-related death due to myocardial infarction. Results for progression-free and overall survival were encouraging. The authors conclude that pembrolizumab plus lenvatinib showed promising activity in patients with pleural mesothelioma, with considerable toxicity.