Mesothelioma is a rare cancer of the lining around the lungs or abdomen caused almost exclusively by asbestos exposure, with a long latency period of 20–50 years. It is an aggressive disease with a poor prognosis, but combination immunotherapy has produced responses that were unimaginable with chemotherapy alone.
What's actually going on in research
Nivolumab plus ipilimumab — combining two checkpoint inhibitors — has become a new first-line standard for unresectable pleural mesothelioma, producing durable responses in a disease where chemotherapy produced only modest benefit. Surgery remains controversial and is being studied in large head-to-head trials to determine whether it extends life in selected patients. Antibody-drug conjugates targeting mesothelin, which is highly expressed in mesothelioma, are in active clinical trials.
Dual checkpoint immunotherapy
Combining nivolumab and ipilimumab as first-line treatment for pleural mesothelioma improved survival over chemotherapy in a landmark trial, and follow-on trials are testing more combinations.
Mesothelin-targeted therapy
Antibody-drug conjugates and immunotoxins targeting mesothelin — a protein highly expressed in mesothelioma — are in mid-stage trials for patients who have progressed on prior therapy.
Surgery in pleural mesothelioma
Whether radical pleurectomy/decortication or other surgical approaches extend survival is being evaluated in properly powered head-to-head trials, as this question has been debated for decades.
What to know before you search
Eligibility requires confirmed malignant pleural or peritoneal mesothelioma, performance status, prior chemotherapy history, and tissue for mesothelin expression testing.
What types of trials are currently open
- Immunotherapy trials — Testing dual and novel checkpoint inhibitor combinations for pleural and peritoneal mesothelioma.
- Mesothelin-targeted trials — Evaluating antibody-drug conjugates, CAR-T cells, and immunotoxins targeting mesothelin.
- Surgical trials — Testing extended pleurectomy vs. chemotherapy-only approaches head-to-head.
- Peritoneal mesothelioma trials — Evaluating HIPEC, systemic therapy, and immunotherapy for abdominal mesothelioma.
- Supportive care trials — Testing management of dyspnea, pleural effusion, and pain in advanced mesothelioma.
Recently added Mesothelioma trials
A 2-part Phase 1/2 Open-label Trial on ODM-212
An open-label, multi-site, multi-cohort phase 1/2 trial to be conducted in 2 parts (dose escalation and dose expansion/optimisation)
Multidimensional Omics Analysis in Malignant Pleural Mesothelioma
Malignant pleural mesothelioma (MPM) is a rare and incurable cancer. Most patients are diagnosed with unresectable disease for which treatment options are limited. The lack of prognostic biomarkers further complicates the decision-making. Recently, the introduction of immune checkpoint inhibitors (ICIs) has marked a shift but has failed to produce significant benefits for a large proportion of patients. Maximizing the efficiency of ICIs and developing new protocols to improve drug efficacy is the best possible strategy for improving the life expectancy and quality of life of patients with MPM. This study aims to characterize the organization of the immune system infiltrating mesothelioma and the dynamics of its interaction with the tumor. The rationale is that deciphering this complexity will help improve our understanding of the mechanisms underlying this disease and provide a new tool to optimize the use of ICIs in these patients.
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