Overall Survival for Patients With MPM Since Inclusion of Immunotherapy in Treatment Guidelines

If untreated, the survival of patients with malignant pleural mesothelioma (MPM) is less than 12 months. Immunotherapy is one important treatment advance that was added to the National Comprehensive Cancer Network (NCCN) Guidelines for Malignant Pleural Mesothelioma in 2017. Results of a recent study that assessed the impact of immunotherapy on overall survival (OS) in patients with MPM were presented at WCLC 2023 in Singapore.

The study identified 20,069 diagnoses of MPM in the National Cancer Database from 2004 to 2012 and 17,015 diagnoses between 2013 and 2019. OS improved between the two periods, with a median OS of 9.49 months and 5-year OS of 8.4% in patients diagnosed from 2004 to 2012 and a median OS of 11.79 months and 5-year OS of 13.5% in patients diagnosed from 2013 to 2019. A significant increase in diagnoses of epithelioid MPM in the latter group was observed, from 35.55% to 44.79% of all cases (P<.0001).

Results also showed that the number of patients receiving immunotherapy increased each year, with 12 patients receiving immunotherapy in 2004 compared with 491 patients in 2019. Immunotherapy improved median OS by 5 to 7 months across all histologic groups, including epithelioid, biphasic, and sarcomatoid (P<.0001 for all), with a median OS in all patients receiving immunotherapy of 17.28 months. Among patients with epithelioid histology, there was a median OS of 15.04 months without immunotherapy and 20.63 months with immunotherapy (P<.0001). The most notable improvement in OS was seen in patients with sarcomatoid histology, with a median OS of 4.4 months without immunotherapy and 11.4 months with immunotherapy (P<.0001).

The researchers concluded that “immunotherapy has revolutionized the treatment of patients with MPM,” with a steady increase in its use over time and a notable increase after the inclusion of immunotherapy as a second-line treatment option in the NCCN guidelines in 2017 and subsequent adoption in the clinic.

Source: Roof L, Wei W, Stevenson J. Impact of inclusion of immunotherapy in national treatment guidelines on survival outcomes in malignant pleural mesothelioma. Abstract of a poster presented at the 2023 World Conference on Lung Cancer; September 9-12, 2023; Singapore.