Immune checkpoint
therapy (ICT) with
nivolumab has been widely used to treat
malignant pleural mesothelioma (MPM) since clinical trials confirmed its efficacy. However, only a few clinical trials have been conducted for the treatment of sarcomatoid MPM, which is a rare histological type of MPM. Additionally, clinical reports of sarcomatoid MPM are scarce. Therefore, the benefits and risks of
nivolumab treatment for sarcomatoid MPM remain unclear. The present report describes the treatment of 3 cases of sarcomatoid MPM (all 3 were men) with
nivolumab monotherapy. In all three cases,
nivolumab was effective despite variations in the
duration of treatment, although side effects were observed in 2 patients.
Programmed death ligand 1 (PD-L1) expression was positive in all 3 cases. In particular, the patient with the highest PD-L1 expression had the most rapid response of the 3 patients, and the effect lasted as long as those of the other 2, despite receiving the smallest number of doses of
nivolumab. It has been reported that sarcomatoid MPM tends to respond poorly to
chemotherapy and express higher levels of PD-L1 than epithelial MPM; thus, ICT may be necessary in these cases. This case series suggests that ICT with
nivolumab is a promising treatment option for sarcomatoid MPM.