Salvage Resection After Immunotherapy in Refractory Malignant Pleural Mesothelioma

Kian C Banks; Mihir J Chaudhary; Diana S Hsu; Colin M Mooney; Jeffrey B Velotta

doi:10.1016/j.athoracsur.2022.01.011

Salvage Resection After Immunotherapy in Refractory Malignant Pleural Mesothelioma

Ann Thorac Surg. 2022 Nov;114(5):e357-e359. doi: 10.1016/j.athoracsur.2022.01.011. Epub 2022 Jan 31.

Authors

Kian C Banks¹, Mihir J Chaudhary², Diana S Hsu², Colin M Mooney², Jeffrey B Velotta³

Affiliations

¹ Department of Surgery, University of California, San Francisco, Oakland, California. Electronic address: kian.banks@ucsf.edu.
² Department of Surgery, University of California, San Francisco, Oakland, California.
³ Department of Thoracic Surgery, Kaiser Permanente Northern California, Oakland, California.

PMID: 35104447
DOI: 10.1016/j.athoracsur.2022.01.011

Abstract

A 78-year old man presenting with epithelial malignant pleural mesothelioma (MPM) underwent multidisciplinary review at our institution. We offered surgical resection with adjuvant chemotherapy, but the patient declined. After 6 months, his disease progressed, and he opted for dual immunotherapy with ipilimumab and nivolumab; however, pneumonitis developed after treatment initiation. Immunosuppression controlled the pneumonitis, but his MPM progressed, so salvage surgical resection was offered. Left extrapleural pneumonectomy was successfully performed with an unremarkable recovery. Final pathology revealed stage III biphasic mesothelioma. This report demonstrates the feasibility of salvage resection for progression of MPM after immunotherapy.

Publication types

Case Reports

MeSH terms

Aged
Humans
Immunotherapy
Ipilimumab
Male
Mesothelioma* / pathology
Mesothelioma* / surgery
Mesothelioma, Malignant*
Nivolumab
Pleural Neoplasms* / pathology
Pleural Neoplasms* / surgery
Pneumonectomy
Radiotherapy, Adjuvant

Substances

Nivolumab
Ipilimumab