Sarcomatoid malignant pleural mesothelioma treated with nivolumab: A case series

Hashimoto,Kentaro; Ozasa,Hiroaki; Yoshizawa,Akihiko; Yoshida,Hiroshi; Ogimoto,Tatsuya; Hosoya,Kazutaka; Yamazoe,Masatoshi; Ajimizu,Hitomi; Funazo,Tomoko; Yoshida,Hironori; Sakamori,Yuichi; Hirai,Toyohiro

doi:10.3892/ol.2022.13522

Sarcomatoid malignant pleural mesothelioma treated with nivolumab: A case series

Authors:
- Kentaro Hashimoto
- Hiroaki Ozasa
- Akihiko Yoshizawa
- Hiroshi Yoshida
- Tatsuya Ogimoto
- Kazutaka Hosoya
- Masatoshi Yamazoe
- Hitomi Ajimizu
- Tomoko Funazo
- Hironori Yoshida
- Yuichi Sakamori
- Toyohiro Hirai
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Affiliations: Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto‑shi, Kyoto 606‑8507, Japan, Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto‑shi, Kyoto 606‑8507, Japan
Published online on: September 22, 2022 https://doi.org/10.3892/ol.2022.13522
Article Number: 402
Copyright : © Hashimoto et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].

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Abstract

Immune checkpoint therapy (ICT) with nivolumab has been widely used to treat malignant pleural mesothelioma (MPM) since clinical trials confirmed its efficacy. However, only a few clinical trials have been conducted for the treatment of sarcomatoid MPM, which is a rare histological type of MPM. Additionally, clinical reports of sarcomatoid MPM are scarce. Therefore, the benefits and risks of nivolumab treatment for sarcomatoid MPM remain unclear. The present report describes the treatment of 3 cases of sarcomatoid MPM (all 3 were men) with nivolumab monotherapy. In all three cases, nivolumab was effective despite variations in the duration of treatment, although side effects were observed in 2 patients. Programmed death ligand 1 (PD‑L1) expression was positive in all 3 cases. In particular, the patient with the highest PD‑L1 expression had the most rapid response of the 3 patients, and the effect lasted as long as those of the other 2, despite receiving the smallest number of doses of nivolumab. It has been reported that sarcomatoid MPM tends to respond poorly to chemotherapy and express higher levels of PD‑L1 than epithelial MPM; thus, ICT may be necessary in these cases. This case series suggests that ICT with nivolumab is a promising treatment option for sarcomatoid MPM.

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