Invited discussant of CheckMate 743, Pilar Garrido, MD, PhD, pointed out there has been little progress in treating patients with malignant pleural mesothelioma over the past 15 years, and there are limited therapeutic options. Dr. Garrido is Associate Professor of Medical Oncology at Universidad de Alcalá and Head of the Thoracic Tumours Section in the Medical Oncology Department at the University Hospital Ramón y Cajal, Madrid.

Pilar Garrido, MD, PhD

“The updated results show that combination immunotherapy [with nivolumab plus ipilimumab] continued to provide a survival benefit in a subgroup of patients. However, better characterization of predictive biomarkers will be crucial to improving these results,” she told listeners.

Dr. Garrido noted that median progression-free survival was similar overall for both treatment arms. However, chemotherapy outperformed immunotherapy early in the trial, further underscoring the need for predictive biomarkers. But she questioned the value of the exploratory analysis of biomarkers. “The study was not powered to detect differences in outcomes based on PD-L1 expression, and the PD-L1 < 1% subset was a small size,” she commented.

The findings related to the four-gene inflammatory score showed a benefit with immunotherapy in the high-score group alone. Dr. Garrido cautioned that interpretation is limited because it was an exploratory analysis and the RNA-evaluable population comprised just 54% of the total study population. 

DISCLOSURE: Dr. Garrido has served as a consultant or advisor to AbbVie, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, GlaxoSmithKline, Janssen Oncology, Lilly, MSD Oncology, Novartis/Pfizer, Pfizer, Roche Pharma AG, and Takeda; has an immediate family member who has served as a consultant or advisor to Boehringer Ingelheim, Gebro, Janssen Biotech, and Nordic Group; has participated in a speakers bureau for AstraZeneca, Bristol Myers Squibb, Boehringer Ingelheim, Janssen Oncology, MSD Oncology, Novartis, Pfizer, Roche Pharma AG, and Takeda; has an immediate family member who has participated in a speakers bureau for Boehringer Ingelheim, Janssen, and Nordic Group; has been reimbursed for travel, accommodations, or other expenses by AstraZeneca, Bristol Myers Squibb, and Roche; and has held other relationships with Janssen Oncology and Novartis.