Search

Background: Malignant pleural mesothelioma (MPM) is a rare thoracic malignancy with high morbidity and mortality. A combination of systemic therapy and surgery may be a promising modality for the treatment of MPM, but evidence-based medicine is still lacking., Case Description: Here we report a case of MPM. The patient presented to hospital with cough and sputum. After ineffective symptomatic treatment, computed tomography (CT) examination suggested a malignant tumor of pleural origin. Positron emission tomography/computed tomography (PET/CT) examination suggested no lymph node metastasis or distant metastasis. The pathologic diagnosis of MPM was confirmed after CT-guided puncture biopsy. Next, she underwent 3 courses of neoadjuvant chemotherapy combined with dual immunotherapy (carboplatin and pemetrexed combined with anti-CTLA4 and anti-PD-1), resulting in significant tumor shrinkage. After obtaining the patient's consent and completing a preoperative evaluation, we modified the extrapleural pneumonectomy (EPP) and pleurectomy/decortication (P/D) by performing a lower lobe resection and partial pleurectomy of the left lung. Intraoperative rapid frozen pathology suggested that the margins of the tumor were negative and complete resection was achieved. The postoperative pathology report showed 10% residual viable tumor, so the major pathological response (MPR) was achieved after treatment., Conclusions: MPM might respond well to neoadjuvant chemotherapy and dual immunotherapy, improving the probability of complete surgical resection and attaining an encouraging pathologic response., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tlcr.amegroups.com/article/view/10.21037/tlcr-24-195/coif). The authors have no conflicts of interest to declare., (2024 Translational Lung Cancer Research. All rights reserved.)

Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tlcr.amegroups.com/article/view/10.21037/tlcr-22-617/coif). TH serves as an unpaid editorial board member of Translational Lung Cancer Research from January 2022 to December 2023. AR serves as an unpaid editorial board member of Translational Lung Cancer Research from November 2020 to October 2022. RAR serves as an unpaid editorial board member of Translational Lung Cancer Research from January 2022 to December 2023. MP serves as an unpaid editorial board member of Translational Lung Cancer Research from October 2021 to September 2023. RAR has been a consultant for Amgen, Ipsen Biopharmaceuticals, Novartis, Advanced Accelerator Applications, Curium Pharma, EMD Serono, Astra-Zeneca. He has also received research funding (to institution) from Merck & Co and Aadi Biosciences. He is also on the speaker bureaus for Ipsen Biopharmaceuticals and Astra-Zeneca. Mariano Provencio received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events and consulting fees from BMS, Astra Zéneca, MSD, Roche, Takeda and Pfizer. Jay M. Lee reports advisory board/consultant of Astrazeneca, Bristol Myers Squibb, Genentech, Novartis, Roche; research support from Genentech, Novartis; steering committee of Genentech, Novartis; speaker’s bureau of AstraZeneca, Genentech, Roche; stock from Moderna; patents of UCLA. Antonio Passaro received honoraria for consulting, advisory role or lectures from AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly, Jansenn, Merck Sharp & Dohme, Roche Genentech, Novartis, MundiPharma, Daiichi Sankyo, eCancer and Medscape. TC reports speaker fees/honoraria from The Society for Immunotherapy of Cancer, Bristol Myers Squibb, Roche, Medscape, and PeerView; travel, food and beverage expenses from Dava Oncology; advisory role/consulting fees from AstraZeneca, Bristol Myers Squibb, EMD Serono, Merck & Co., Genentech, and Arrowhead Pharmaceuticals; and institutional research funding from AstraZeneca, Bristol Myers Squibb, Boehringer Ingelheim and EMD Serono. The other authors have no conflicts of interest to declare.