Systematic review and meta-analysis of safety and efficacy of PD-(L)1 immune checkpoint inhibitors for previously treated advanced malignant mesothelioma

Recent studies have shown evidence of activity of PD-(L)1 immune checkpoint inhibitors (ICIs) for advanced stage malignant mesothelioma (asMM). A systematic review and meta-analysis of 15 studies (1064 patients) evaluated PD-(L1) ICIs as second-line treatment for asMM. The pooled objective response rate was 16% and the pooled disease control rate was 57%. The pooled median progression-free survival was 4.53 months (95% CI 3.40-5.65) and the pooled median overall survival was 10.51 months (9.03-12.00).Treatment-related adverse events were seen in 69% of patients (95% CI 0,50-0.83) and immune-related adverse events in 28% (15-46). There were no significant differences between pembrolizumab, nivolumab, and avelumab for all the outcomes. The authors conclude that PD-(L)1 ICIs had activity and acceptable safety as second-line treatment for asMM.