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CASE REPORT article

Front. Oncol.
Sec. Cancer Immunity and Immunotherapy
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1410322

Major response of a peritoneal mesothelioma to nivolumab and ipilimumab: a case report, molecular analysis and review of literature

Provisionally accepted
Marie-Florence Reveneau Marie-Florence Reveneau 1,2*Julien Masliah Julien Masliah 1Manuel Fernandez Manuel Fernandez 3*Abdenour Ouikene Abdenour Ouikene 2*Bernard Dron Bernard Dron 4*Innocenti Dadamessi Innocenti Dadamessi 4*Charles Dayen Charles Dayen 5*Lisa Golmard Lisa Golmard 1*Bruno Chauffert Bruno Chauffert 2*
  • 1 Department of Genetics, Institut Curie, Paris, Ile-de-France, France
  • 2 Department of Medical Oncology, Centre Hospitalier de Saint-Quentin, Saint-Quentin, France
  • 3 Department of Radiology, Centre Hospitalier de Saint-Quentin, Saint-Quentin, France
  • 4 Department of Digestive Surgery, Centre Hospitalier de Saint-Quentin, Saint-Quentin, France
  • 5 Department of Pneumology, Centre Hospitalier de Saint-Quentin, Saint-Quentin, France

The final, formatted version of the article will be published soon.

    Malignant peritoneal mesothelioma (MPM) is a rare tumor associated with a poor prognosis and a lack of consensus regarding treatment strategies. While the Checkmate 743 trial demonstrated the superiority of first-line nivolumab and ipilimumab over chemotherapy in malignant pleural mesothelioma (MPlM), few studies have assessed the effectiveness of immunotherapy against MPM, due to its rarity. Here, we report a major and sustained 12-month response in a 74-year-old female patient who received the anti-PD-1 nivolumab and the anti-CTLA4 ipilimumab as first-line therapy for diffuse MPM. PD-L1 was expressed and BAP1 expression was lost, as shown by immunohistochemistry, however the BAP1 gene was not mutated. Our findings suggest a role for ICI in non-resectable diffuse MPM exhibiting PD-L1 overexpression and loss of BAP1 expression, and instill new hope in their treatment. To our knowledge, this is the second reported case of dual immunotherapy used as first-line in MPM with a major clinical response. To investigate the clinical outcome, we conducted additional molecular analyses of the MPM tumor and we reviewed the literature on immunotherapy in MPM to discuss the role of PD-L1 and BAP1.

    Keywords: Peritoneal mesothelioma, Nivolumab, ipilimumab, BAP1, PD-L1, molecular stratification

    Received: 31 Mar 2024; Accepted: 05 Jul 2024.

    Copyright: © 2024 Reveneau, Masliah, Fernandez, Ouikene, Dron, Dadamessi, Dayen, Golmard and Chauffert. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Marie-Florence Reveneau, Department of Genetics, Institut Curie, Paris, cedex 05, Ile-de-France, France
    Manuel Fernandez, Department of Radiology, Centre Hospitalier de Saint-Quentin, Saint-Quentin, France
    Abdenour Ouikene, Department of Medical Oncology, Centre Hospitalier de Saint-Quentin, Saint-Quentin, France
    Bernard Dron, Department of Digestive Surgery, Centre Hospitalier de Saint-Quentin, Saint-Quentin, France
    Innocenti Dadamessi, Department of Digestive Surgery, Centre Hospitalier de Saint-Quentin, Saint-Quentin, France
    Charles Dayen, Department of Pneumology, Centre Hospitalier de Saint-Quentin, Saint-Quentin, France
    Lisa Golmard, Department of Genetics, Institut Curie, Paris, cedex 05, Ile-de-France, France
    Bruno Chauffert, Department of Medical Oncology, Centre Hospitalier de Saint-Quentin, Saint-Quentin, France

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