Patients with mesothelioma may gain similar benefit from immunotherapy as chemotherapy, and good responders may provide important clues to novel treatment for the thousands of new cases each year. Data from the PROMISE-meso trial presented at the ESMO Congress 2019 highlight the need to understand the biological mechanisms whereby mesothelioma, which is incurable, adapts to immunotherapy in some patients but not in others, resulting in variations in treatment response.
PROMISE-meso compared the effects of immunotherapy with the checkpoint inhibitor, pembrolizumab, and standard chemotherapy after patients with mesothelioma relapsed on or after first-line treatment.
“In PROMISE-meso, nearly four times more patients responded to immunotherapy than standard chemotherapy, but unfortunately these responses did not delay progression or improve survival. These findings are disappointing but, as in previous studies, some patients benefitted from immunotherapy for long periods. If we can find out how this happens, we will have a better idea of which patients should preferentially receive this treatment over chemotherapy,” said study author Dr. Sanjay Popat, Royal Marsden Hospital NHS Foundation Trust, London, UK. “Nevertheless, whilst pembrolizumab was not superior to chemotherapy, survival was similar, and so pembrolizumab may represent an alternative.”
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