Malignant pleural mesothelioma (MPM) · line 2 · Nivolumab monotherapy (mesothelioma 2L, CONFIRM)
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
Knowledge-base record for audit. Provisional clinical content: this is not a prescription. An oncologist must verify original sources, applicability and review status. Full rules and constraints are in the YAML.
| Line of therapy | 2 |
|---|---|
| Track | standard |
| Linked regimen | REG-NIVO-MONO-MESOTHELIOMA-2L |
| ID | IND-MESOTHELIOMA-2L-NIVO |
|---|---|
| Type | Indication |
| Status | reviewed 2026-05-07 | pending_clinical_signoff |
| Diseases | DIS-MESOTHELIOMA |
| Sources | SRC-CONFIRM-FENNELL-2021 SRC-NCCN-NSCLC-2025 |
Notes
CONFIRM (PMID 34090562) is the first phase-3 RCT with OS benefit for 2L MPM. First platinum-based therapy was pemetrexed+cisplatin/carboplatin in most patients. Nivolumab benefit observed in both epithelioid (majority of patients) and non-epithelioid subtypes — distinct from the 1L CheckMate-743 pattern where non-epithelioid derived substantially greater benefit. PD-L1 expression status is NOT required for patient selection; CONFIRM enrolled an unselected population and OS benefit was consistent across PD-L1 subgroups. Active autoimmune disease, prior organ transplantation, and ongoing corticosteroids >10 mg/d prednisone equivalent are clinical contraindications (not KB entity IDs — hard_contraindications remains []). NCCN source note: MPM is managed under a dedicated NCCN Mesothelioma guideline separate from NSCLC. SRC-NCCN-NSCLC-2025 is used as proxy here (same approach as IND-MESOTHELIOMA-1L-NIVO-IPI). A dedicated NCCN mesothelioma source should be added when available.
Used By
Algorithms
ALGO-MESOTHELIOMA-2L- ALGO-MESOTHELIOMA-2L