Five-Year Data Show Sustained Survival Benefit for Nivolumab-Ipilimumab in Mesothelioma
The CheckMate 743 trial reports five-year outcomes for nivolumab plus ipilimumab versus chemotherapy as first-line treatment for unresectable pleural mesothelioma, demonstrating sustained overall survival benefit.
The randomized phase III CheckMate 743 study demonstrated significant overall survival benefit with nivolumab plus ipilimumab versus chemotherapy as first-line treatment for unresectable pleural mesothelioma, with five-year clinical outcomes now reported.
The trial enrolled 605 patients who were randomly assigned to receive either nivolumab plus ipilimumab (n = 303) or chemotherapy (n = 302). The median age was 69 years in both treatment arms, with 77% of patients being male. The majority of patients had an ECOG performance status of 0 or 1, with 62% having a performance status of 1 in the nivolumab plus ipilimumab arm and 57% in the chemotherapy arm.
Tumor histology was epithelioid in 76% of patients in the nivolumab plus ipilimumab arm and 75% in the chemotherapy arm, while nonepithelioid histology was present in 24% and 25% of patients, respectively. Sarcomatoid histology accounted for 12% of patients in both arms. The majority of patients had advanced disease, with 53% having stage IV disease in the nivolumab plus ipilimumab arm and 49% in the chemotherapy arm.
The study population included patients from multiple geographic regions, with 58% from Europe in both treatment arms, 11% from North America in the nivolumab plus ipilimumab arm versus 9% in the chemotherapy arm, and 9% from Asia in the nivolumab plus ipilimumab arm versus 13% in the chemotherapy arm. Current or former smokers comprised 57% of patients in both treatment arms.
The trial evaluated efficacy outcomes, biomarker analyses, treatment switching-adjusted analyses, and safety profiles. The study included analyses of both the overall randomly assigned population and subgroups based on epithelioid and nonepithelioid histology.