Breaking Through: Immunotherapy Innovations in Pleural Mesothelioma.

The prognosis of pleural mesothelioma (PM) is poor and conventional chemotherapy regimens have shown limited antitumor activity. Recent use of immune checkpoint inhibitors (ICIs) has shown promise, with CheckMate-743 trial establishing nivolumab plus ipilimumab as first line treatment in unresectable PM. Nevertheless, real-world applicability as well as differential benefit of immunotherapy according to histologic are areas of active debate. In addition, increased incidence of immune-related adverse events (IRAEs) and high discontinuation rates highlight the need for careful patient selection. While ICIs represent a significant advancement in PM treatment, ongoing research is necessary to refine their use, potentially through biomarker-informed approaches, and manage associated toxicities. This review highlights the evolving landscape of immunotherapy and associated controversies in PM.