{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T01:49:09Z","timestamp":1782524949356,"version":"3.54.5"},"reference-count":58,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T00:00:00Z","timestamp":1756771200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>While clinical trials confirm the therapeutic value of PD-1\/PD-L1 and CTLA-4 inhibitors in diffuse pleural mesothelioma, their real-world safety and efficacy profiles remain incompletely defined. This meta-analysis synthesizes clinical evidence to comprehensively evaluate these outcomes, addressing an urgent need for robust real-world evidence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>PubMed, Embase, the Cochrane Library were systematically searched for relevant studies. Outcomes including median progression-free survival (mPFS), median overall survival (mOS), 1-year overall survival (1-y OS), 1 year progression-free survival (1-year PFS),objective response rate (ORR), disease control rate (DCR), complete response(CR),partial response (PR), stable disease(SD), progressive disease(PD), treatment-related adverse events (TRAEs) and \u2265grade 3 TRAEs were extracted for further analysis. The risk of bias was assessed by subgroup analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>14 articles with 1345 patients were identified and subjected to meta-analysis. With regard to survival analysis, the pooled mOS and mPFS were 6.66 months (95%CI 4.85-9.16) and 2.92 months (95%CI 2.23-3.83), respectively. In terms of tumor response, the pooled ORR and DCR were 21% (95%CI 6%-41%) and 49% (95%CI 27%-71%), respectively. The pooled AEs rate and \u2265 grade 3 AEs rate were 94% (95%CI 86%-99%) and 44% (95%CI 30%-58%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>PD-1\/PD-L1 inhibitors combined with CTLA-4 inhibitors have shown effective clinical responses in the treatment of Diffuse Pleural Mesothelioma (DPM). Although the incidence of adverse reactions is high, they are generally tolerable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Systematic Review Registration<\/jats:title><jats:p><jats:uri>www.inplasy.com<\/jats:uri>, identifier INPLASY202520045.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2025.1578746","type":"journal-article","created":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T05:32:49Z","timestamp":1756791169000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Efficacy and safety of PD-1\/PD-L1 and CTLA-4 immune checkpoint inhibitors in the treatment of diffuse pleural mesothelioma: a systematic review and 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