Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2023; 11(22): 5296-5302
Published online Aug 6, 2023. doi: 10.12998/wjcc.v11.i22.5296
Zimberelimab plus chemotherapy as the first-line treatment of malignant peritoneal mesothelioma: A case report and review of literature
Xiao-Dong Peng, Zhen-Yu You, Lian-Xiang He, Qi Deng
Xiao-Dong Peng, Zhen-Yu You, Department of Cancer, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
Lian-Xiang He, Qi Deng, Department of Medical Affairs, Guangzhou Gloria Bioscience Co.,Ltd., Beijing 100005, China
Author contributions: Deng Q is responsible for writing the manuscript; He LX revised this manuscript; Peng XD and You ZY provided idea and case, and reviewed the manuscript; all authors have read and approve the final manuscript.
Informed consent statement: The patient provided a written informed consent form.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Dong Peng, MD, Chief Physician, Department of Cancer, The First Affiliated Hospital of Nanchang University, No. 1519 Dongyue Avenue, Nanchang 330006, Jiangxi Province, China. pxddhbb@163.com
Received: March 1, 2023
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
Abstract
BACKGROUND

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.

CASE SUMMARY

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.

CONCLUSION

The outcome of the present case demonstrates the promising anti-tumor activity of immunochemotherapy to treat inoperable MPeM in the future.

Keywords: Malignant peritoneal mesothelioma, Immune checkpoint inhibitors, Immunotherapy, Zimberelimab, Chemotherapy, Case report

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.