Malignant pleural mesothelioma is an aggressive cancer with limited therapeutic options. Pemetrexed plus platinum is often the first treatment option that clinicians turn to.
There are now several options for second treatment therapy. This is useful in patients with relapsed mesothelioma. Yet some of these treatment therapies remain controversial.
Several drugs were recently introduced to treat relapsed mesothelioma. A new study conducted a meta-analysis to check the efficacy of these drugs.
After Chemotherapy, What Comes Next?
Nivolumab alone or nivolumab plus ipilimumab provided significantly longer patient survival. In fact, treatment with nivolumab plus ipilimumab was found to have the best survival rates.
Other treatments had a good survival rate compared with a placebo. These other treatments included tremelimumab, vorinostat, and chemotherapy (CTX). There was also asparagine–glycine–arginine–human tumor necrosis factor plus CTX. And finally nivolumab alone and nivolumab with ipilimumab.
All treatments produced significant progression-free survival (PFS) benefits compared with placebo. But nivolumab plus ipilimumab ranked first for survival in mesothelioma patients.
Second-Line Treatments in Relapsed Mesothelioma
The research team identified several randomized controlled trials. They focused on trials on second-line treatments in patients with relapsed mesothelioma.
They used a cumulative ranking curve called SUCRA to analyze the values. All values were ranked for the included treatments according to each outcome.
Relapsed malignant mesothelioma patients who received nivolumab and ipilimumab had significantly longer survival. This was compared with patients who received a placebo.
Nivolumab plus ipilimumab had the best overall survival ranking, followed by nivolumab.
All the other drug and treatment options produced good benefits.
Nivolumab plus ipilimumab is the best second-line treatment in patients with relapsed mesothelioma.
Tsai, Yu-Chen, Hsiao-Ling Chen, Tai-Huang Lee, Hsiu-Mei Chang, Kuan-Li Wu, Cheng-Hao Chuang, Yong-Chieh Chang et al. “Salvage Therapy for Relapsed Malignant Pleural Mesothelioma: A Systematic Review and Network Meta-Analysis.” Cancers 14, no. 1 (2021): 182. https://doi.org/10.3390/cancers14010182