The phase 2 CHIMERA trial is evaluating whether adding pembrolizumab to standard chemotherapy before and after surgery can improve outcomes for patients with resectable pleural mesothelioma. About 40 adults with previously untreated stage I to IIIa epithelioid or biphasic disease are expected to enroll.
Patients will receive three cycles of pembrolizumab combined with platinum-based chemotherapy and pemetrexed before surgery. After undergoing pleurectomy/decortication or extended pleurectomy/decortication, they will receive up to 14 additional cycles of pembrolizumab.
The main goal of the study is to increase the pathological complete response rate from the historical 5% seen with chemotherapy alone to 18%. Researchers will also evaluate tumor response, event-free survival, overall survival, safety, and biomarkers that may predict which patients benefit most. The trial builds on the success of immunotherapy in advanced pleural mesothelioma and aims to determine whether the same approach can improve outcomes for patients with earlier-stage disease undergoing surgery.