Nintedanib as Switch Maintenance Treatment of Pleural Malignant Mesothelioma

Inclusion Criteria: * Histological diagnosis of unresectable Malignant Pleural Mesothelioma (MPM); * Response or Stable disease according to modified RECIST criteria \[48\] after first line platinum-pemetrexed chemotherapy for 4-6 cycles; * Last platinum chemotherapy dose administered within 60 days (i.e. randomization must occur within 60 days from the last dose of the last cycle of platinum-pemetrexed chemotherapy); * Age \>18 years; * ECOG performance status (PS) 0-2; * Life expectancy of at least 12 weeks in the opinion of the investigator; * Adequate bone marrow, liver and renal function as assessed by the following laboratory requirements to be conducted within 7 days prior to start of first dose Exclusion Criteria: * prior systemic anticancer therapy including cytotoxic therapy or immune-checkpoint inhibitor, for MPM, other than first line platinum-based doublet chemotherapy; * previous extra-pleural pneumonectomy (other forms of previous surgery eg pleurectomy are acceptable); * previous Vascular Endothelial Growth Factor (VEGF) inhibitors (eg bevacizumab, sorafenib, etc); * treatment with other investigational drugs or treatment in another clinical interventional trial within the past 4 weeks before start of therapy or concomitantly with the trial; * patients that, in the opinion of the investigator, have reduced performance status by 2 ECOG levels (e.g. PS 0 to 2 or PS 1 to 3) from beginning to completion of 1st line chemotherapy; * radiotherapy (with the excepti…