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Mesotelioma pleural maligno (MPM) · linha 2 · Nivolumab em monoterapia (mesoteloma 2L, CONFIRM)

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Fonte YAML: registo completo

Notas

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.

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Algoritmos

• ALGO-MESOTHELIOMA-2L - ALGO-MESOTHELIOMA-2L