Published online Aug 6, 2023. doi: 10.12998/wjcc.v11.i22.5296
Peer-review started: March 1, 2023
First decision: May 25, 2023
Revised: June 21, 2023
Accepted: July 11, 2023
Article in press: July 11, 2023
Published online: August 6, 2023
Processing time: 155 Days and 3.8 Hours
Malignant peritoneal mesothelioma (MPeM) is a rare cancer with a poor prognosis at advanced stage, and the standard first-line treatment for inoperable patients is chemotherapy. Although combining programmed cell death 1 (PD-1) inhibitors with chemotherapy is generally considered safe and effective in several malignant solid tumors, there are few reports regarding initial immunochemotherapy in advanced MPeM.
Here, to our knowledge, we present the first case of a patient with epithelioid subtype MPeM, who was treatment-naïve and benefited from initial PD-1 inhibitor plus standard chemotherapy with a prolonged progression-free survival (PFS) and good tolerance. A 49-year-old man was admitted to our hospital for a persistent burning sensation in the abdomen. Computed tomography revealed a solid mass in the lower abdomen, which was subsequently diagnosed histologically as epithelioid subtype MPeM by core needle biopsy. The patient received eight cycles of pemetrexed 800 mg (day 1), cisplatin 60/50 mg (day 1–2), and zimberelimab (PD-1 inhibitor) 240 mg (day 1) every 3 wk. He achieved significant reduction of peritoneal tumors with remarkable improvement in symptoms. The best tumor response was partial remission with a final PFS of 7 mo. No immune-related adverse event occurred during the combination treatment.
The outcome of the present case demonstrates the promising anti-tumor activity of immunochemotherapy to treat inoperable MPeM in the future.
Core Tip: Malignant peritoneal mesothelioma (MPeM) is a rare cancer with a poor prognosis at advanced stage. Here, we present the first case of a patient with epithelioid subtype MPeM, who was treatment-naïve and benefited from initial programmed cell death 1 inhibitor plus standard chemotherapy with a prolonged progression-free survival and good tolerance. We would like to share our experience with immunochemotherapy, which will help clinicians make appropriate decisions in the future.