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Read the tumour type under the microscope first: non-epithelioid tumours should get immunotherapy up front; epithelioid tumours can reasonably get either immunotherapy or chemo-immunotherapy.
In mesothelioma the histological subtype read by histopathology and immunohistochemistry now directs the first-line choice, making this a diagnostic-therapeutic pairing. Sarcomatoid and biphasic tumours are chemoresistant but more immune-infiltrated, whereas epithelioid tumours retain sensitivity to pemetrexed-based chemotherapy. In pre-specified subgroups of CheckMate 743, nivolumab plus ipilimumab gave a large survival advantage over chemotherapy in non-epithelioid disease but only a small one in epithelioid disease, and pembrolizumab plus chemotherapy in IND.227 / KEYNOTE-483 and BEAT-meso showed the same pattern. Guidelines therefore favour immunotherapy up front for non-epithelioid tumours, while epithelioid tumours can receive either immunotherapy or chemo-immunotherapy.
Shares CheckMate 743, Mesothelioma, Ipilimumab, Nivolumab.
Shares Epithelioid vs sarcomatoid (biphasic) mesothelioma, Mesothelioma, Pemetrexed, Immune checkpoint inhibitors.
Shares Mesothelioma, Ipilimumab, Pemetrexed, Nivolumab.
Shares CheckMate 743, Ipilimumab, Nivolumab.
Shares Mesothelioma, Ipilimumab, Nivolumab, Immune checkpoint inhibitors.
Shares Ipilimumab, Pemetrexed, Nivolumab, Immune checkpoint inhibitors.
Shares Pemetrexed, Nivolumab, Pembrolizumab, Immune checkpoint inhibitors.
Shares CheckMate 743, Mesothelioma, Ipilimumab, Nivolumab.