Unprecedented long‐term survival in a patient with malignant pleural mesothelioma treated with subsequent systemic chemo‐ and immunotherapeutic regimens

Pleural mesothelioma is a rare disease with a dismal prognosis and few therapeutic options. Until recently the median overall survival for a pleural mesothelioma patient was up to 2 years, with few exceptional cases of patients achieving a longer survival. Here, we report the clinical case of a patient whose survival spanned over 10 years. The patient underwent several systemic treatments, including three different chemotherapy lines (cisplatin‐pemetrexed, vinorelbine and platinum rechallenge) and two immunotherapy regimens using immune checkpoint inhibitors (anti CTLA‐4 tremelimumab and anti PD‐1 nivolumab). At the time this report was written, the patient was off‐treatment, asymptomatic and with a stable radiological disease. Our case demonstrates that a prolonged survival with a preserved quality of life may be reached in selected patients through the exploitation of the available treatments in an expertise setting. Pleural mesothelioma is a disease with a dismal prognosis. Here, we show an unusual case of a patient with pleural mesothelioma with adenomatoid histology (1), with nonsurgically operable disease. This patient was managed with multiple lines of systemic therapy, achieving long lasting survival from 2012 (2) to date (3). Disease control is still ongoing and the patient is asymptomatic with a good performance status.