Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 16, 2022; 10(23): 8284-8290
Published online Aug 16, 2022. doi: 10.12998/wjcc.v10.i23.8284
Immunotherapy combined with antiangiogenic agents in patients with advanced malignant pleural mesothelioma: A case report
Tian-Tian Xuan, Guang-Yi Li, Si-Bo Meng, Zhan-Mei Wang, Lin-Li Qu
Tian-Tian Xuan, Si-Bo Meng, Zhan-Mei Wang, Lin-Li Qu, Department of Medical Oncology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao 266035, Shandong Province, China
Guang-Yi Li, Department of Respiratory, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao 266035, Shandong Province, China
Author contributions: Xu TT and Qu LL reviewed the literature and contributed to manuscript drafting; Xu TT, Li GY, Meng SB, and Wang ZM analyzed and interpreted the imaging findings; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that there are no conflicts of interest related to this report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lin-Li Qu, MD, PhD, Chief Doctor, Department of Medical Oncology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, No. 758 Hefei Road, Qingdao 266035, Shandong Province, China. qulinli2021@163.com
Received: January 16, 2022
Peer-review started: January 16, 2022
First decision: March 16, 2022
Revised: April 12, 2022
Accepted: June 21, 2022
Article in press: June 21, 2022
Published online: August 16, 2022
Processing time: 197 Days and 6.3 Hours
Abstract
BACKGROUND

Malignant pleural mesothelioma has limited therapeutic options and a poor outcome. Antiangiogenic agents might increase the efficacy of immunotherapy as second-line treatment of advanced-stage malignancies.

CASE SUMMARY

A patient with stage IIIB pleural mesothelioma received second-line treatment with a combination of pembrolizumab, bevacizumab and chemotherapy following standard chemotherapy under the guidance of second-generation sequencing. He achieved a partial response after four cycles of treatment with progression-free survival of 5 mo. Pembrolizumab was suspended due to grade 2 immunerelated pneumonia, which was resolved by oral glucocorticoids. However, disease progression was observed after immunotherapy rechallenge and anlotinib therapy. The patient had disease progression, multiorgan dysfuntion and died suddenly in October 2019.

CONCLUSION

The combination of immune checkpoint inhibitor, anti-angiogenic agents and chemotherapy showed effective response for advanced pleural mesothelioma, but with adverse reactions.

Keywords: Pleural mesothelioma; Immune checkpoint inhibitor; Next-generation Sequencing; Immunerelated pneumonia; Immunotherapy rechallenge; Case report

Core Tip: A patient with stage IIIB pleural mesothelioma received second-line treatment with a combination of pembrolizumab, bevacizumab and chemotherapy following standard chemotherapy, and achieved partial response after four cycles, with progression-free survival of 5 mo.