Intratumor Heterogeneity Predicts Niraparib Benefit in Relapsed Mesothelioma
Dean Fennell, MD, PhD, Leicester Mesothelioma Program, Leicestershire, United Kingdom, discusses results from the investigator-initiated phase 2 NERO trial evaluating niraparib plus active symptom control (ASC) versus ASC alone in patients with relapsed mesothelioma.
Results demonstrated that the addition of niraparib improved progression-free survival in this patient population. Upon incorporating an innovative artificial intelligence (AI) deep-learning model, ARTIMES, to better measure disease response integrated multiomics, AI analysis revealed that intratumor heterogeneity was a key predictor of benefit from niraparib, associated with features such as chromosomal instability, STING activation, and NK-cell infiltration. These findings highlight the potential of combining AI-driven imaging and molecular profiling to personalize PARP inhibitor therapy in mesothelioma.
These results were presented at the 2025 European Society for Medical Oncology (ESMO) Congress in Berlin, Germany.
Source:
Fennell DA, Bzura A, Oketch J, et al. 3D-response and multiomic correlates of niraparib in relapsed mesothelioma: NERO, a randomized clinical trial in patients with relapsed mesothelioma. Presented at the 2025 ESMO Congress. October 17-21, 2025; Berlin, Germany. LBA106
