A combination of atezolizumab (Tecentriq) and bevacizumab appeared effective and safe in patients with advanced malignant peritoneal mesothelioma, according to results from a small single-arm trial.
The combination achieved an objective response rate (ORR) of 40% in patients who had progressed on or were resistant to prior platinum-pemetrexed (Alimta) chemotherapy, reported Kanwal Raghav, MD, of MD Anderson Cancer Center in Houston, and colleagues in Cancer Discovery.
The responses were “robust and durable … with meaningful prolongation of survival,” the team wrote.
“There is absolutely no other therapy approved for use in this setting,” Raghav told MedPage Today. “The only treatments we use are cytotoxic chemotherapies, like gemcitabine, all of which have response rates of less than 10%.”
Malignant peritoneal mesothelioma is an aggressive, although extremely rare (only about 275 new cases per year in the U.S.), malignancy that has few treatment options.
Therapy for the disease is largely based on data extrapolated from studies of pleural mesothelioma, Raghav explained. “But there are many differences between these diseases. Epidemiologically speaking, pleural mesothelioma is associated with lots of asbestos exposure, but peritoneal mesothelioma might not be. And peritoneal mesothelioma is more common in women than men and is diagnosed at an earlier age and more often with advanced disease.”
He noted that National Comprehensive Cancer Network guidelines recommend first-line platinum-pemetrexed chemotherapy for both types of mesothelioma, “but after failure of this first-line therapy there is no recommended standard or FDA-approved therapy for advanced [malignant peritoneal mesothelioma], and a critical unmet need of novel therapies for this novel disease exists.”
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