Internationally recognized investigator Paul Baas, MD, PhD, recently reviewed decades of advancements in treatments for mesothelioma during his opening keynote address at the 2023 European Lung Cancer Congress. Dr. Baas, chief of the department of Thoracic Oncology at the Netherlands Cancer Institute and an appointed professor in Thoracic Oncology at the University Hospital of Leiden, spoke as the recipient of the 2023 Heine H. Hansen Award.
The award, established in 2015 by IASLC and the European Society for Medical Oncology (ESMO), honors Heine H. Hansen’s lifetime of international contributions to lung cancer research and education. It is presented annually to recognize an investigator who has also made a significant, international contribution to lung cancer research and education.
“I met Dr. Hansen a few times when I started in the 90s, and I will always remember him as a visionary for lung cancer and for always believing that we must move research forward with the right studies to improve survival in lung cancer patients,” Dr. Baas said after receiving the award.
Dr. Baas characterized the progression of treatments for mesothelioma throughout his career as having transitioned from hopeless to hopeful. He recalled the difficulty of studying mesothelioma as a young professional when few pharmaceutical companies were interested in funding research for the rare cancer. Indeed, from 1990-2000, researchers could only conduct phase II single-arm and single-drug studies, he said.
“We did not even look very much at progression-free survival,” Dr. Baas said. “We focused on the overall response rate.”
Some progress was made in the first 15 years of the 21st century, such as the genesis of phase III randomized studies, the introduction of antifolates, and additional translational research. However, chemotherapy was still viewed as the sole treatment option for patients with mesothelioma at the time.
In 2016, Dr. Baas and a team of researchers began what would become a signature achievement in his career, the CheckMate 743 study.1 Dr. Baas and his team concluded that first-line nivolumab plus ipilimumab provided significantly meaningful improvements in patients’ overall survival rates versus standard-of-care.
“We had a gain of four months in median overall survival, even if the patients had received some immuno-oncology drug after the chemotherapy,” Dr. Baas explained. “The hazard ratio was 0.73, and this was something we had not seen in mesothelioma treatment before. It was highly significant.”
For patients with non-epithelial mesothelioma, which cannot be treated with chemotherapy, immunotherapies are an especially vital breakthrough.
While Dr. Baas celebrated these improvements in mesothelioma therapies, he also emphasized the need for continuous advancements. Recent studies have begun to analyze whether combining chemotherapy and immunotherapy would be an ideal treatment option for certain patients.
He also advocated for improved research, care, and support for nations outside of the Western Hemisphere. In addition to bolstering these countries’ medical and psychosocial support infrastructures, Dr. Baas also highlighted the need for targeted legal reforms, such as banning asbestos.
As chair of the IASLC Mesothelioma Committee, he is working to improve mesothelioma care in such countries as Indonesia, India, South Africa, and more.
“This is a huge undertaking, which I think will go on for quite a long time,” Dr. Baas said.
References
- 1. Baas P, Scherpereel A, Nowak AK, et al. First-line nivolumab plus ipilimumab in unresectable malignant pleural mesothelioma (CheckMate 743): a multicentre, randomised, open-label, phase 3 trial [published correction appears in Lancet. 2021 Feb 20;397(10275):670]. Lancet. 2021;397(10272):375-386. doi:10.1016/S0140-6736(20)32714-8
