Role of Durvalumab (Anti-PD-L1) in the Management of Mesothelioma: A Systematic Review of the Current Literature

Abstract

Introduction Mesothelioma is a rare and rapidly advancing tumor that usually emerges on the mesothelial surfaces of the pleura or peritoneum. Despite being a well-recognized rare disease for decades, the only approved primary treatment protocol has been platinum-based treatments plus pemetrexed, whether or not bevacizumab is administered. Immunotherapy-based immune checkpoint inhibitors demonstrated a promising antitumor efficacy in a variety of cancer types. This is a systematic review of the current role of durvalumab in the management of this condition. Methods A systematic search was carried out through the databases and search engines. Regardless of study design, line of therapy, mode of therapy, or Eastern Cooperative Oncology Group (ECOG) performance status, studies that primarily focused on the outcomes of treating this disease with durvalumab were eligible for inclusion. After the initial and full-text screenings, five studies were reviewed. Results The median age of the total 235 patients was 66.9 years. Males comprised 174 (74.04%) of the cases, with 61 (25.95%) cases being female. The Epithelioid mesothelioma subtype accounted for 194 (82.55%) of the patients. Durvalumab, in combination with pemetrexed cisplatin/carboplatin as therapy, was used in 109 (48.38%) cases. Durvalumab and tremelimumab were used in the treatment of 40 (17.02%) cases, of which 17 (7.23%) had retreatment with both immunotherapies. Among the patients who underwent durvalumab treatment, 69 (29.36% ) of the individuals previously received carboplatin/pemetrexed and cisplatin/pemetrexed. Conclusion Durvalumab can be utilized as an effective alternative for malignant pleural mesothelioma treatment, providing positive results and acceptable safety profiles.