Epithelioid vs sarcomatoid (biphasic) mesothelioma
Mesothelioma comes in a slower 'epithelioid' form and an aggressive 'sarcomatoid' form. Chemotherapy works better in the first; immunotherapy helps most in the second.
Epithelioid (~60-70%) has median survival 14-18 months with chemotherapy; sarcomatoid (~10-20%) and biphasic (~20%) respond poorly to chemotherapy (median OS 8-12 months) but derived the largest benefit from nivolumab-ipilimumab in CheckMate 743 (OS 18.1 vs 8.8 months) and from pembrolizumab-chemotherapy. Histology is therefore the first branch in first-line decisions. BAP1 loss is common in epithelioid tumours; CDKN2A/MTAP deletion in sarcomatoid.
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Shares BEAT-meso (ETOP 13-18), IND.227 / KEYNOTE-483, CheckMate 743, Histology → first-line choice in mesothelioma.
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Shares CheckMate 743, Mesothelioma.
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