CheckMate 743 Underscores the Importance of Managing Toxicities in MPM

Solange Peters, MD, PhD, the president of the European Society of Medical Oncology (ESMO), discusses the ways in which oncologists can manage toxicities in patients with unresectable malignant pleural mesothelioma (MPM).

The phase 3 CheckMate 743 trial (NCT02899299) examined nivolumab (Opdivo) in combination with ipilimumab (Yervoy) and found it to significantly extend overall survival (OS) in patients with MPM. The study was conducted on over 600 patients with untreated MPM and at the 3-year follow-up, even patients who stopped the treatment showed better results compared with those who received platinum-based chemotherapy.

Peters explains the importance of communication and how it is a main topic of importance within the trial. If patients and physicians are able to communicate well, more reassurance and comfort is provided and treatment outcomes will likely improve. 

Transcription:

0:08| Management of toxicities is now the topic of many guidelines, and the main thing to say to colleagues is to create your circle of expertise around you and follow the guidelines, because no intervention should be delayed and nothing should be derived from the guidance, because you can manage toxicities without any high-grade AE and without any death if you do it well. But management is something which is well-established by guidelines and has to be locally established within a small circle of specialists. But it should prevent any severe toxicity or any deaths related to toxicity nowadays, because we know how to manage toxicity.

0:51 | The message of this trial is more about communication to the patient. If a patient has to stop because of toxicity, the message and the tone you use might not [need to] be very negative because you can tell them that despite having to stop in all of these trials with nivolumab/ipilimumab, the long-term outcome remains particularly good, meaning that the toxicity also reflects some overdue immune reaction. I think it's more about reassuring or comforting our patient that it doesn't mean that the outcome will be worse than expected because of toxicity. The outcome is pretty good when people have to stop due to toxicity.