Survival Statistics

Mesothelioma Survival Statistics
Current Data Through 2025
5-Year Survival (All)	15%
Localized Stage	23% (5-year)
Peritoneal Type	65% (5-year)
Immunotherapy OS	18.1 months median
New Treatments	86% disease control (VT3989)
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Executive Summary

Mesothelioma survival rates have improved significantly with advances in immunotherapy, targeted therapy, and surgical techniques, though the disease remains serious. Current SEER data shows overall 5-year relative survival of 15%, with dramatic variations based on disease location, stage at diagnosis, and cell type. Peritoneal mesothelioma patients achieving complete surgical cytoreduction now experience 5-year survival rates exceeding 65%, while patients treated with the immunotherapy combination nivolumab plus ipilimumab show 23% 3-year survival compared to 15% with chemotherapy alone. Understanding these statistics helps patients and families make informed treatment decisions and pursue appropriate legal compensation for asbestos exposure.

Key Facts

Key Facts: Mesothelioma Survival Statistics 2025

Overall 5-Year Survival: 15% across all stages and types combined Localized Disease: 23% 5-year survival rate when cancer remains contained Regional Spread: 15% 5-year survival when cancer has spread to nearby structures Distant Metastasis: 11% 5-year survival for advanced disease Peritoneal vs. Pleural: 65% versus 12% 5-year survival rates Epithelioid Histology: 14-18 months median survival, approximately 14% 5-year survival Sarcomatoid Histology: 4-8 months median survival, approximately 4% 5-year survival Immunotherapy Benefit: 18.1 months median OS versus 14.1 months with chemotherapy Non-Epithelioid Improvement: Immunotherapy doubles survival (18.1 vs. 8.8 months) Specialized Centers: Survival rates 2.5 times higher than national averages Complete Cytoreduction: 104 months median survival for peritoneal patients with CC-0 Gender Disparity: Women show approximately 50% better survival than men

What Are Current Mesothelioma Survival Rates by Stage?

Stage at diagnosis remains one of the most important prognostic factors for mesothelioma patients. The SEER database, which represents the most comprehensive cancer statistics in the United States, categorizes survival by localized, regional, and distant disease stages rather than traditional TNM staging.

Localized mesothelioma, where the cancer remains confined to the pleura or peritoneum without spread to lymph nodes or distant sites, shows 23% 5-year relative survival. Regional disease, indicating spread to nearby lymph nodes or adjacent structures, demonstrates 15% 5-year survival. Distant metastatic disease, where cancer has spread to remote organs or distant lymph nodes, shows 11% 5-year survival.

The AJCC Cancer Staging System Version 9, now applied to cases diagnosed from 2025 forward, provides more detailed staging criteria that better predict outcomes. Early-stage patients (stages I-II) who undergo aggressive multimodal treatment including surgery typically achieve median survival of 21-24 months, with select patients surviving 5 years or longer.

"Stage at diagnosis significantly influences both treatment options and outcomes. We work to ensure families understand how staging affects not only prognosis but also their legal timeline for pursuing compensation."

— Paul Danziger, Founding Partner, Danziger & De Llano

How Does Mesothelioma Type Affect Survival?

The location where mesothelioma develops dramatically influences survival outcomes. Peritoneal mesothelioma, arising in the abdominal lining, maintains substantially better prognosis than pleural mesothelioma affecting the lung lining.

Peritoneal Mesothelioma demonstrates 65% 5-year survival compared to just 12% for pleural disease. One-year survival rates are 92% for peritoneal versus 73% for pleural patients. This dramatic difference reflects both the disease biology and availability of highly effective cytoreductive surgery with heated intraperitoneal chemotherapy (HIPEC).

Pleural Mesothelioma represents approximately 80% of all cases and carries median survival of 12-21 months depending on stage, histology, and treatment approach. However, patients treated at specialized mesothelioma centers achieve significantly better outcomes, with some programs reporting survival rates 2.5 times national averages.

Pericardial and Testicular Mesothelioma are rare variants representing less than 3% of cases combined. Testicular mesothelioma paradoxically shows the best prognosis among all types when treated surgically, while pericardial mesothelioma carries poor prognosis due to its location around the heart.

What Role Does Cell Type Play in Prognosis?

Mesothelioma cell type (histology) represents another critical prognostic factor that significantly influences treatment options and survival expectations.

Epithelioid Mesothelioma accounts for 50-70% of cases and carries the most favorable prognosis. Median survival ranges from 14-18 months, with approximately 14% 5-year survival. This cell type responds best to chemotherapy, immunotherapy, and surgical interventions.

Sarcomatoid Mesothelioma represents 10-20% of cases and demonstrates the poorest outcomes, with median survival of only 4-8 months and approximately 4% 5-year survival. Historically resistant to chemotherapy, this aggressive subtype now shows dramatically improved outcomes with immunotherapy. The CheckMate 743 trial demonstrated median survival of 18.1 months versus 8.8 months with chemotherapy for non-epithelioid disease—effectively doubling survival.

Biphasic Mesothelioma contains both epithelioid and sarcomatoid cells, with prognosis depending on the ratio of each cell type. Tumors with predominantly epithelioid features behave more favorably than those with dominant sarcomatoid components.

✓ Immunotherapy Breakthrough for Non-Epithelioid Disease The 2025 ASCO Guidelines now recommend nivolumab plus ipilimumab as the preferred first-line treatment for non-epithelioid mesothelioma based on the dramatic survival benefit demonstrated in CheckMate 743 (hazard ratio 0.46).

How Has Immunotherapy Changed Survival Outcomes?

The approval of nivolumab plus ipilimumab in 2020 marked the first new systemic treatment for mesothelioma in over 15 years and has substantially improved survival expectations.

The CheckMate 743 trial, with 3-year follow-up data representing the most mature efficacy analysis available, demonstrated median overall survival of 18.1 months with immunotherapy versus 14.1 months with chemotherapy (hazard ratio 0.73). Three-year survival rates reached 23% versus 15%, with 3-year progression-free survival of 14% versus just 1% for chemotherapy.

Critically, 28% of patients who responded to immunotherapy maintained their response at 3 years, compared to 0% in the chemotherapy group—demonstrating the potential for durable disease control in selected patients.

New molecular analyses have identified predictive biomarkers for immunotherapy response. Patients with triple mutations (BAP1/CDKN2A/CDKN2B) plus PD-L1 positivity achieved median survival of 15.8 months versus 9.4 months with chemotherapy alone.

"The immunotherapy revolution has fundamentally changed how we approach mesothelioma cases. Patients now have treatment options that weren't available even five years ago, which affects both their medical decisions and their legal strategy."

— Rod De Llano, Founding Partner, Danziger & De Llano

What New Treatments Are Improving Survival in 2025?

Several breakthrough therapies are demonstrating remarkable efficacy and may further improve survival outcomes in the coming years.

VT3989 (TEAD Inhibitor) received FDA Fast Track Designation in October 2025 after demonstrating exceptional results in heavily pretreated patients. This first-in-class therapy achieved 86% disease control rate and 32% objective response rate, with median progression-free survival of approximately 10 months—more than double the 15-week benchmark for salvage chemotherapy. A Phase 3 registrational trial is planned for early 2026.

CAR-T Cell Therapy continues showing remarkable durability. Memorial Sloan Kettering's mesothelin-targeted CAR-T program has demonstrated responses lasting beyond 5 years in early patients, with one patient first treated in 2019 remaining disease-controlled as of late 2024. Chinese trials reported 100% objective response rate at higher doses, including durable complete responses.

BNT327/PM8002 (Bispecific Antibody) demonstrated 51.6% confirmed objective response rate and 90.3% disease control rate in Phase 2 trials, representing one of the highest response rates seen in unresectable mesothelioma.

ATOMIC-meso (ADI-PEG20) achieved its primary endpoint for non-epithelioid mesothelioma, demonstrating a 29% reduction in death risk and quadrupling 3-year survival compared to placebo plus chemotherapy.

How Does Specialized Treatment Center Care Affect Survival?

Treatment at specialized mesothelioma centers dramatically improves survival outcomes compared to community cancer centers.

Brigham and Women's Hospital (International Mesothelioma Program) has documented patients surviving 20+ years, including one patient who survived 29 years after extrapleural pneumonectomy before passing in 2025. The program has performed over 1,448 mesothelioma surgeries and offers the proprietary Four-Gene Ratio Test for personalized treatment selection.

MD Anderson Cancer Center reports peritoneal mesothelioma outcomes with 40% objective response rate and 85% one-year survival using atezolizumab plus bevacizumab. Their Ki-67 biomarker analysis showed patients with Ki-67 ≤9% achieving median survival of 86.6 months versus just 10.3 months for those with Ki-67 >9%.

Moffitt Cancer Center reports survival rates approximately 2.5 times national averages: 73% one-year and 12% five-year for pleural mesothelioma, with 65% five-year survival for peritoneal disease (increasing to 80% with CRS-HIPEC plus chemotherapy).

Memorial Sloan Kettering published the world's largest single-center outcomes study (945 patients) and demonstrated 51% disease control with tazemetostat for BAP1-mutant disease.

ℹ Specialized Center Advantage Patients treated at NCI-designated cancer centers with dedicated mesothelioma programs consistently achieve better outcomes through access to clinical trials, multidisciplinary teams, and high surgical volumes. Over 80 cancer centers in the US are certified for Tumor Treating Fields therapy.

What Is the Prognosis for Peritoneal Mesothelioma with CRS-HIPEC?

Cytoreductive surgery with heated intraperitoneal chemotherapy (CRS-HIPEC) has transformed peritoneal mesothelioma from universally fatal to potentially curable in selected patients.

The completeness of cytoreduction represents the paramount prognostic factor:

• CC-0 (Complete Cytoreduction): 104 months median survival
• CC-1 (Minimal Residual): 30 months median survival
• CC-2 (Incomplete): 2.7 months median survival

Peritoneal Cancer Index (PCI), measuring tumor distribution across abdominal regions, also strongly predicts outcomes:

• PCI 0-20: 103 months median survival
• PCI 21-39: 33 months median survival

The 2025 PSM Consortium Consensus Guidelines emphasize complete cytoreduction as the treatment goal, with cisplatin plus doxorubicin emerging as the preferred HIPEC regimen (53 months mean survival versus 38 months with single agents).

Australian single-center data demonstrates 53 months median survival and 49% 5-year survival, while conditional survival analysis shows patients surviving 3 years post-surgery achieve 6.1 years median additional survival.

How Do Demographic Factors Influence Survival?

Patient demographics significantly affect mesothelioma outcomes, with notable disparities by gender and age.

Gender Disparity: Women demonstrate approximately 50% better 5-year survival (19-21%) compared to men (8-9%). This difference may reflect hormonal factors, later average age at diagnosis for women, different exposure patterns (often secondary exposure through household contact), and higher likelihood of epithelioid histology in female patients.

Age at Diagnosis: Patients diagnosed before age 50 show 75% one-year survival compared to 44% for those over 65. Younger patients more often tolerate aggressive multimodal treatment including surgery, improving their long-term outcomes.

Performance Status: Patients with good functional status (ECOG 0-1) consistently demonstrate better treatment tolerance and survival across all mesothelioma types and stages.

"When my father was diagnosed, we felt overwhelmed by the statistics. What we learned is that every case is different, and getting to a specialized center made all the difference in his care and our family's peace of mind."

— David Foster, Client Advocate, Danziger & De Llano

What Emerging Biomarkers Predict Survival?

Advanced biomarker testing is transforming mesothelioma prognosis from population-based statistics to individualized predictions.

Liquid Biopsy (ctDNA): A landmark 2025 Nature Medicine study validated circulating tumor DNA monitoring as a powerful prognostic tool. Patients achieving undetectable ctDNA at cycle 3 day 1 demonstrated median progression-free survival of 19.84 months versus just 1.41 months for those with detectable ctDNA. Those achieving ≥95% ctDNA reduction showed median PFS of 23.26 months versus 1.68 months—a more than 13-fold difference.

BAP1 Mutation Status: Present in over 50% of mesotheliomas, BAP1 mutation paradoxically predicts better survival (median 5 years versus less than 1 year without mutation) while also indicating potential sensitivity to targeted therapies like tazemetostat.

Ki-67 Proliferation Index: For peritoneal mesothelioma, Ki-67 ≤9% predicts median survival of 86.6 months versus 10.3 months for Ki-67 >9%—an 8-fold difference.

Methylation-Based Classification: cfMeDIP-seq liquid biopsy can distinguish epithelioid from sarcomatoid histology with 98% accuracy and identify prognostic methylation signatures non-invasively.

⚠ Important Legal Consideration Improved survival through newer treatments can extend the time available for pursuing legal compensation, but statutes of limitations still apply. Consulting with experienced mesothelioma attorneys early ensures families preserve all legal options.

Why Does Early Legal Action Matter for Mesothelioma Patients?

Understanding survival statistics is essential not only for treatment planning but also for protecting legal rights and family financial security.

Mesothelioma patients may be entitled to compensation from multiple sources:

• Asbestos Trust Funds: Over $30 billion available across 60+ active trusts
• Personal Injury Lawsuits: Against negligent asbestos manufacturers and employers
• Veterans Benefits: VA disability compensation, DIC, and healthcare
• Workers' Compensation: For occupational asbestos exposure

Statutes of limitations vary by state but typically range from 1-6 years from diagnosis. While improved survival means more time for treatment, it does not extend legal deadlines. Experienced mesothelioma attorneys can pursue compensation while patients focus on treatment and quality of life.

"We've seen how financial security allows families to focus on what matters most—time together and access to the best available care. The companies responsible for asbestos exposure should be held accountable, regardless of how long ago the exposure occurred."

— Michelle Whitman, Attorney, Danziger & De Llano

Get Help Today

If you or a loved one has been diagnosed with mesothelioma, understanding survival statistics is just the first step. Connecting with specialized treatment centers and experienced legal professionals can help maximize both treatment outcomes and financial recovery.

Call Danziger & De Llano today at (866) 222-9990 for a free, confidential case evaluation. Our team has decades of experience helping mesothelioma patients and families navigate both the medical and legal aspects of this disease.

✓ What You Can Expect: Free case evaluation with no obligation Identification of all potential asbestos exposure sources Connection with leading mesothelioma treatment specialists Pursuit of maximum compensation from all available sources No upfront costs—we only get paid if you recover compensation