# CheckMate 743: first-line nivolumab plus ipilimumab in unresectable pleural mesothelioma

Source: https://onco.cc/key-papers/paper-checkmate-743-lancet-2021/  
OnCo record `paper-checkmate-743-lancet-2021` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Dual immunotherapy with nivolumab and ipilimumab lengthened survival compared with platinum-pemetrexed chemotherapy in pleural mesothelioma, the first improvement in first-line treatment in almost twenty years, with the largest gain in non-epithelioid tumours.

## Summary

Phase 3 trial of 605 patients with untreated unresectable malignant pleural mesothelioma randomised to nivolumab plus ipilimumab or platinum plus pemetrexed.

Median overall survival was 18.1 versus 14.1 months (hazard ratio 0.74); in non-epithelioid histology it was 18.1 versus 8.8 months (hazard ratio 0.46), while the difference in epithelioid disease was small. Three-year survival was 23 versus 15 percent.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: The Lancet
- Year: 2021
- DOI: 10.1016/S0140-6736(20)32714-8
- Authors: Baas P, Scherpereel A, Nowak AK, et al.
- Findings: Median overall survival 18.1 vs 14.1 months; hazard ratio 0.74.; Non-epithelioid: 18.1 vs 8.8 months; hazard ratio 0.46.
- What it means: Nivolumab-ipilimumab is the preferred first-line treatment for non-epithelioid pleural mesothelioma and an option in epithelioid disease alongside chemo-immunotherapy.
- Caveats: Open-label; early crossing of survival curves indicates some patients do worse without chemotherapy.; Epithelioid benefit was modest.

## Sources

- Lancet 2021: https://doi.org/10.1016/S0140-6736(20)32714-8
- PubMed: https://pubmed.ncbi.nlm.nih.gov/33485464/

## Connected records

- cancers: [Peritoneal mesothelioma](https://onco.cc/cancers/peritoneal-mesothelioma/), [Pleural mesothelioma](https://onco.cc/cancers/pleural-mesothelioma/)
- drugs: [Ipilimumab](https://onco.cc/drugs/ipilimumab/), [Nivolumab](https://onco.cc/drugs/nivolumab/)
- trials: [CheckMate 743](https://onco.cc/trials/checkmate-743/)
- journals: [The Lancet](https://onco.cc/journals/lancet/)

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