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WCLC 2025 | Key clinical and translational updates in mesothelioma at WCLC 2025
Nicolas Girard, MD, Institut Curie, Paris, France, comments on the current standard of care for patients with advanced mesothelioma and the potential of biomarkers in this rare thoracic cancer. Recent research has shown encouraging results in patients with resectable diffuse pleural mesothelioma receiving neoadjuvant nivolumab. With promising data on mutations in key genes and the prognostic value of BAP1 loss, integrating biomarker assessment into real-life practice for diagnosis will also play a key role in the future. This interview took place at 2025 World Conference on Lung Cancer (WCLC) in Barcelona, Spain.
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Transcript
Mesothelioma is one of the rare thoracic cancers. Standard of care for patients with advanced disease is either combined immunotherapy with nivolumab plus ipilimumab or combination of chemo plus pembrolizumab. We have landmark trials that demonstrate the benefit of immunotherapy as compared to chemotherapy. Several abstracts presented looking at biomarkers and which are the biomarkers in mesothelioma...
Mesothelioma is one of the rare thoracic cancers. Standard of care for patients with advanced disease is either combined immunotherapy with nivolumab plus ipilimumab or combination of chemo plus pembrolizumab. We have landmark trials that demonstrate the benefit of immunotherapy as compared to chemotherapy. Several abstracts presented looking at biomarkers and which are the biomarkers in mesothelioma. These are mostly based on mutations in some key genes including BAP1, TP53, NF2, MTAP. And we have new data coming from large databases such as the IASLC database looking at the prognostic value of these alterations. For example, this is the first time that we have in a large cohort correlation between BAP1 immunohistochemistry and BAP1 using NGS panel. Pretty good correlation. Also the prognostic value of BAP1 loss associated with a better outcome in mesothelioma patients, more frequent in the epithelioid histologic subtype. Also some data, very nice data looking at resectable mesothelioma with neoadjuvant nivolumab plus ipilimumab. Nice data showing the value of circulating free DNA to predict the chance of surgery in those patients. It’s a quite good correlation between ctDNA clearance and the chance of surgery and the survival outcome. So maybe a potential tool for the future and to better select the patient for surgery. Also very nice data again in a trial for resectable mesothelioma looking at single cell signatures and again to better understand the correlation between the tumor microenvironment landscape and the mutation profile. So again very nice data looking at these aspects. The other point and the key question in mesothelioma is whether we should integrate the assessment of these biomarkers in real life not only for the diagnosis but also for the assessment of the prognosis, the stratification of patients, and the prediction of the efficacy of therapies, so very important to continue to work on these aspects in mesothelioma.
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