**9. Conclusion**

The prognosis of MPM remains poor. A PD-1/PD-L1 blockade is an effective treatment option for MPM. The combination of nivolumab (anti-PD-1 antibody) and ipilimumab (anti-CTLA-4 antibody) could be a standard first-line treatment. Additionally, the combination of an ICI with conventional chemotherapy might be a promising treatment option. Cellular therapies and cancer vaccines must overcome many challenges, such as T-cell migration to the tumor and infiltration into the tumor. Improvements in cancer therapies are urgently needed to overcome these difficulties. Further research with large-scale clinical trials are needed to clarify the utility and safety of these immunotherapies in MPM. In addition, in this new era of precision medicine, we need to develop biomarkers to identify which patients would benefit from ICI-ICI combinations, ICI plus chemotherapy, or cellular therapy.
