The Anti-CTLA-4 Monoclonal Antibody Tremelimumab in Malignant Mesothelioma

Inclusion Criteria: * Histologically or cytologically confirmed MM * Have received only one prior systemic chemotherapy platinum-based regimen for advanced MM * Measurable disease, defined at least 1 unidimensionally measurable lesion \> 20 mm by conventional techniques or \> 10 mm by spiral CT scan (modified RECIST criteria) * Disease not amenable to curative surgery * No known brain metastasis * Age 18 and over * Performance status 0-2 * Life expectancy \> 12 weeks * Adequate hematologic, hepatic and renal function * Platelet count \> 75000/mm3 * Absolute granulocyte count \> 1000/mm3 * Hemoglobin \> 9 g/dL * Bilirubin total \< 1.5 x ULN (Upper limited normal), except patients with documented Gilbert's syndrome, who must have a total bilirubin \< 3.0 mg/dl * AST and ALT \< 2.5 x ULN ( \< 5 x ULN if documented liver metastasis are present) * Creatinine level \< 2mg/dl or calculated creatinine clearance \> 60 mL/min as determined by the Cockcroft Gault equation. * Not pregnant or nursing * Fertile patients must use effective contraception * Patient must be willing and able to provide written informed consent, and the trial have to be approved by the institutional review board at each institution Exclusion Criteria: * Symptomatic chronic inflammatory or autoimmune disease * Active hepatitis B or C * Prior treatment with tremelimumab or other anti-CTLA-4 antibody or anti-PD1, anti-PDL-1 agents * Clinically relevant cardiovascular disease * History of psychiatric disabilities, potentially interfering with the capability of giving adequate informed consent * Uncontrolled active infections * Other concurrent chemotherapy, immunotherapy, radiotherapy or investigational agents * History of other malignancies except for adequately treated basal cell carcinoma or squamous cell skin cancer or carcinoma of cervix, unless the patient has been disease-free for at least 5 years