Therapeutic advancement for
mesothelioma has been stagnant, with minimal treatment innovation in the past decade. Recently, however,
immune checkpoint blockade (ICB) targeting the programmed death 1 and
cytotoxic T-lymphocyte-associated antigen 4 pathways has revolutionized the treatment of multiple
malignancies and shown promise in
mesothelioma, with multiple agents now recommended in the salvage setting for advanced disease progressive on
platinum-based
chemotherapy. Studies of frontline chemoimmunotherapy and ICB combinations have also been encouraging, and both are likely to become integrated into the frontline treatment strategy for
mesothelioma in the coming years. Other novel
immunotherapy strategies, including
chimeric antigen receptor T-cell
therapy, are being investigated in
mesothelioma. Although early studies have demonstrated the safety of multiple agents, further trials powered for efficacy are needed. In addition, enrolling patients in window-of-opportunity trials of ICB in resectable
mesothelioma and
biomarker-focused correlative studies will be critical to furthering the mechanistic understanding of ICB in
mesothelioma, which in turn will help to uncover
biomarkers of response and resistance in these patients.