Mesothelioma is an uncommon and universally fatal thoracic cancer linked to exposure to asbestos. Until recently, standard of care treatment was chemotherapy; a treatment resulting in a minimal survival extension, and not improved upon for almost twenty years. However, the advent of cancer immunotherapy – and in particular immune checkpoint inhibitors - has resulted in recently approved new treatment options, with more currently under investigation.
This presentation will review the past 5 years of data on immunotherapy in mesothelioma, with a focus on checkpoint blockade. I discuss clinical trials of both single agent and combination checkpoint inhibitors in mesothelioma, plus studies investigating their combination with chemotherapy, and some limited data available on biomarkers of checkpoint blockade efficacy. I will highlight current Australian cooperative group clinical trials and how they integrate with other treatments available to patients. Finally, I will discuss how to consider therapeutic decisions and treatment sequencing for patients with mesothelioma in this new era with more therapeutic choices and an evidence-base that remains limited outside of the pivotal clinical trials.