Malignant pleural mesothelioma is a cancer of the lining around the lung that for a long time was treated only with chemotherapy. This study compared a combination of two immunotherapy drugs (nivolumab and ipilimumab) with chemotherapy. Patients who received immunotherapy typically lived longer (18.1 months versus 14.1 months), and after 2 years 41% of them were alive compared with 27% of patients in the chemotherapy group. The rate of serious side effects was about the same in the two groups, but there were three treatment-related deaths in the immunotherapy group. The right treatment should be chosen together with your treating doctor.
First line
| Drug | Dose | Route | Schedule |
|---|---|---|---|
| Continuous | |||
| Nivolumab | 360 mg | IV, 30-minute infusion | Every 3 weeks |
| Ipilimumab | 1 mg/kg | IV, 30-minute infusion | Every 6 weeks |
On the page “Ipilimumab (Yervoy)” · Other cancers, with nivolumab (FDA label, revised 08/2026)
Doses follow the trial protocol, guideline or official drug label (source given in the notes of each regimen). Before prescribing, check blood counts, renal and hepatic function, drug interactions and the patient’s condition, and adjust the dose according to the drug label.
Nivolumab 3 mg/kg IV every 2 weeks plus ipilimumab 1 mg/kg IV every 6 weeks, for up to 2 years (303 patients).
Pemetrexed 500 mg/m² IV plus cisplatin 75 mg/m² IV or carboplatin AUC 5 mg/mL per min IV, every 3 weeks for up to 6 cycles (302 patients).
Source of the regimen details: Abstract of the paper
Doses are given for the information of specialists, as in this study’s protocol, and are not a prescription. Every drug must be prescribed by the treating physician for the individual patient.
Adults aged 18 years and older with histologically confirmed, unresectable, previously untreated malignant pleural mesothelioma (MPM) and ECOG performance status 0 or 1. The study was conducted at 103 hospitals in 21 countries. Of the 605 participants, 467 (77%) were men and the median age was 69 years (interquartile range 64 to 75).
Primary endpoint: overall survival (OS) in all randomised participants. Safety was assessed in all patients who received at least one dose of study drug.
Grade 3–4 treatment-related adverse events were reported in 91 (30%) of 300 patients treated with nivolumab plus ipilimumab and 91 (32%) of 284 patients treated with chemotherapy. Three treatment-related deaths (1%) occurred in the nivolumab plus ipilimumab group (pneumonitis, encephalitis and heart failure) and one death (less than 1%) in the chemotherapy group (myelosuppression).
Based on the abstract, nivolumab plus ipilimumab improved overall survival compared with standard chemotherapy in unresectable, previously untreated MPM, and it has been approved in the United States for this indication since October 2020. Approval status in other countries and the place of this regimen in current clinical guidelines should be checked separately; these are not reported in the abstract.
The study was open-label, and the reported results come from a prespecified interim analysis (median follow-up 29.7 months). Details of subgroups (such as histological type) and other endpoints are not given in the abstract and should be checked in the full text of the paper.
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.
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