Clinical Trials Mesothelioma
Executive Summary
Mesothelioma clinical trials are research studies that evaluate new treatments, drug combinations, and therapeutic approaches for patients diagnosed with malignant mesothelioma. As of April 2026, ninety-three mesothelioma clinical trials are actively recruiting patients worldwide, with fifty-two enrolling in the United States, spanning immunotherapy, targeted therapy, CAR-T cell therapy, radiation, device-based treatment, and surgical combinations.[1]
Three systemic therapy regimens are now FDA-approved for malignant pleural mesothelioma: cisplatin plus pemetrexed (approved 2004),[2] nivolumab plus ipilimumab (approved October 2020),[3] and pembrolizumab plus pemetrexed plus platinum chemotherapy (approved September 17, 2024).[4][5] The most significant recent milestone is the CheckMate 743 five-year update, published in the Journal of Clinical Oncology in February 2026, confirming that nivolumab plus ipilimumab achieves a 14% five-year overall survival rate versus 6% with chemotherapy (HR 0.74, 95% CI 0.62-0.88).[6] In non-epithelioid disease, the five-year survival gap was even more dramatic: 12% versus 1% (HR 0.48), representing one of the most significant survival benefits reported in this historically treatment-resistant subgroup.[6]
At-a-Glance
Mesothelioma clinical trials at a glance:
- 93 trials recruiting worldwide as of April 2026, 52 of them in the United States — spanning immunotherapy, targeted therapy, CAR-T, radiation, device-based treatment, and surgical combinations[1]
- VT3989 TEAD inhibitor's Phase III trial (sTEADfast, NCT07824986) posted September 2026 — the most clinically advanced TEAD inhibitor achieved 32% objective response rate and 86% disease control rate in 22 patients at the optimized dose, and its registrational trial, the first-ever pivotal trial for a targeted therapy in mesothelioma, is now registered and not yet recruiting[7][8]
- Pembrolizumab plus chemotherapy FDA-approved September 2024 — in KEYNOTE-483, median overall survival was 17.3 months with pembrolizumab plus chemotherapy versus 16.1 months with chemotherapy alone (hazard ratio 0.79).[4] Posted registry results show an objective response rate of 62.2% (138 of 222) versus 38.1% (83 of 218)[9]
- CheckMate 743 five-year data confirm durable immunotherapy benefit — 14% versus 6% five-year overall survival; 17% of responders still in response at five years versus 0% in the chemotherapy arm[6]
- CAR-T cell therapy achieves 83% one-year survival — Memorial Sloan Kettering's intrapleural CAR-T program demonstrated unprecedented durability in mesothelioma, with cells persisting over 100 days in 39% of patients[10]
- BNT327/PM8002 bispecific antibody achieves 51.6% overall response — this PD-L1/VEGF-A bispecific antibody demonstrated exceptional results including 75% response rate in peritoneal mesothelioma patients (8 patients, 100% disease control rate) in a completed Phase II study (NCT05918107, 31 patients); no mesothelioma Phase III trial has been registered as of September 2026[11][12]
- ATOMIC-Meso pegargiminase BLA under FDA review — in the phase 3 ATOMIC-Meso trial of 249 patients with non-epithelioid pleural mesothelioma, median overall survival was 9.3 months with pegargiminase plus chemotherapy versus 7.7 months with placebo plus chemotherapy (hazard ratio 0.71)[13]; the company reported in August 2025 that the BLA had entered FDA substantive review[14]
- UV1 telomerase vaccine granted FDA Fast Track — the NIPU trial demonstrated 31% versus 16% overall response rate and 15.4 versus approximately 11 months median overall survival when UV1 was added to nivolumab plus ipilimumab, earning FDA Fast Track designation in February 2024[15]
- ISM6331 AI-designed drug enters human testing — Insilico Medicine's pan-TEAD inhibitor reached first-in-human dosing in January 2025 after being designed using artificial intelligence in under five years, compared to the typical ten to fifteen year drug development timeline[16]
- NCI CAR-T trial is free to patients — the TNhYP218 trial at the NIH Clinical Center in Bethesda, Maryland provides all medical care at no cost to participants, with some travel expenses covered[17]
- New U.S. cases remain steady at approximately 3,000 per year — mesothelioma continues to be diagnosed decades after asbestos exposure, with a median latency period of 30 to 50 years[18]
| Trial / Metric | Key Finding | Status (April 2026) |
|---|---|---|
| Active Recruiting Trials | 93 worldwide (52 U.S.); 2 Phase III recruiting as of April 2026 (see September 2026 update below — now 1 recruiting, plus VT3989/NCT07824986 posted Sep 2026, not yet recruiting) | As of April 2026[1] |
| eVOLVE-Meso Phase III (NCT06097728) | 863 participants enrolled (actual); AstraZeneca volrustomig (PD-1/CTLA-4 bispecific) + chemotherapy vs. investigator's choice; first-line unresectable pleural mesothelioma | Active, not recruiting (enrollment complete as of Sep 2026)[19] |
| VT3989 TEAD Inhibitor | 32% ORR, 86% DCR, 10-month mPFS at 100 mg 2-on/2-off dose (n=22); Orphan Drug + Fast Track designations; potential approval 2028-2029 | Phase III (NCT07824986) posted Sep 2026, not yet recruiting[7][8] |
| CheckMate 743 Five-Year Update | Nivolumab + ipilimumab: 14% vs. 6% five-year OS; non-epithelioid 12% vs. 1% (HR 0.48); 17% of responders ongoing at 5 years | Published Feb 2026[6] |
| KEYNOTE-483 (Pembrolizumab + Chemo) | 17.3 vs. 16.1 months median OS (HR 0.79); 52% vs. 29% confirmed ORR[5]; non-epithelioid HR 0.57; FDA approved September 2024 | FDA-approved[4] |
| MSK Intrapleural CAR-T (NCT04577326) | Predecessor trial: 83% one-year OS, 72% ORR in mesothelioma (n=18 with pembrolizumab); CAR-T persistence >100 days in 39% | Recruiting[10] |
| BNT327/PM8002 Bispecific Antibody | 51.6% confirmed ORR (31 patients); 75% ORR in peritoneal cohort (8 patients, 100% DCR); Phase II (NCT05918107) completed March 2026 | Phase II completed; no mesothelioma Phase III registered[11][12] |
| ATOMIC-Meso (Pegargiminase) | Non-epithelioid: median OS 9.3 vs. 7.7 months with placebo plus chemotherapy (HR 0.71); 36-month survival 11.9% vs. 3.3%[13] | BLA in FDA substantive review since August 2025[13][14] |
| UV1 Vaccine (NIPU Trial) | 31% vs. 16% ORR; 15.4 vs. ~11 months median OS; FDA Fast Track February 2024 | Phase III planning[15] |
| ISM6331 (AI-Designed Drug) | Pan-TEAD inhibitor; first patient dosed January 2025 in China; FDA Orphan Drug Designation June 2024 | Phase I recruiting[16] |
Key Facts
| Fact | Detail (as of April 2026) |
|---|---|
| Trials actively recruiting | 93 worldwide, of which 52 are enrolling in the United States[1] |
| FDA-approved systemic regimens | Three for malignant pleural mesothelioma: cisplatin + pemetrexed (2004)[2], nivolumab + ipilimumab (October 2020)[3], and pembrolizumab + pemetrexed + platinum (September 17, 2024)[4][5] |
| Longest reported survival benefit | CheckMate 743 five-year update: 14% five-year overall survival with nivolumab + ipilimumab versus 6% with chemotherapy (HR 0.74, 95% CI 0.62-0.88); 12% versus 1% in non-epithelioid disease (HR 0.48)[6] |
| Common eligibility gates | Surgical and radiation trials require performance status WHO 0-1 with FEV1 and DLCO at least 40% predicted[20]; cell-therapy trials require biomarker thresholds — mesothelin expression of at least 10% by immunohistochemistry[10], at least 50% of tumor cells[17], or HLA-A*02 loss of heterozygosity[21] — and generally require at least one prior treatment line |
What Are Mesothelioma Clinical Trials?
Mesothelioma clinical trials are rigorously designed research studies that test new drugs, drug combinations, surgical techniques, radiation approaches, and medical devices in patients with malignant mesothelioma. These studies follow strict protocols approved by institutional review boards and monitored by the FDA to ensure patient safety while evaluating whether new treatments are more effective than existing standards of care.[22]
Clinical trials progress through four phases, each serving a distinct purpose:
| Phase | Purpose | Typical Size | Mesothelioma Trials (2026) |
|---|---|---|---|
| Phase I | Determine safe dosage and identify side effects | 15-30 patients | 23 recruiting[1] |
| Phase I/II | Combined safety and early efficacy evaluation | 30-100 patients | 15 recruiting[1] |
| Phase II | Evaluate treatment effectiveness and further assess safety | 50-300 patients | 19 recruiting[1] |
| Phase III | Compare new treatment against current standard of care for FDA approval | 300-3,000 patients | 2 recruiting + VT3989 opening[1] |
Mesothelioma clinical trials are sponsored by pharmaceutical companies (such as AstraZeneca, Merck, and Bristol-Myers Squibb), the National Cancer Institute, academic medical centers (Memorial Sloan Kettering, MD Anderson, Dana-Farber), and biotechnology companies (Vivace Therapeutics, Insilico Medicine, Verismo Therapeutics).[22]
For patients considering their treatment options, clinical trials provide access to therapies that may offer superior outcomes compared to currently approved regimens. The three FDA-approved systemic treatments for pleural mesothelioma all emerged directly from successful clinical trials, and several investigational approaches now show response rates that exceed approved therapies.[22]
This page catalogues what is currently investigational — trials still enrolling or awaiting results for regimens like TEAD inhibitors, mesothelin-targeted CAR-T cell therapy, and next-generation checkpoint combinations. For the completed, reported relapsed-setting regimens that already have published trial results — RAMES, the nivolumab-ramucirumab HCRN trial, the negative anetumab ravtansine trial, and ASCO/ESMO guideline positioning for second-line therapy — see Second-Line_Systemic_Therapy_for_Pleural_Mesothelioma.
What Phase III Trials Are Currently Recruiting for Mesothelioma?
Phase III trials represent the final stage of clinical testing before FDA approval. These large, randomized studies compare new treatments against the current standard of care. As of September 2026, one Phase III trial is actively recruiting for mesothelioma in the ClinicalTrials.gov registry — Atezomeso (NCT04996017, an Italian-led adjuvant trial) — while eVOLVE-Meso has finished enrollment and is no longer recruiting. A second trial, the VT3989 registrational trial (sTEADfast), was posted to the registry in September 2026 and has not yet opened for enrollment. HIT-Meso, a UK-only proton beam radiotherapy trial, is also recruiting but carries no drug-development phase designation in the registry (phase: NA) and so does not appear in a Phase III count.[23][8][20]
eVOLVE-Meso (NCT06097728) — Enrollment Complete, No Longer Recruiting
The eVOLVE-Meso trial is an AstraZeneca-sponsored Phase III study that evaluates volrustomig (MEDI5752), a novel PD-1/CTLA-4 bispecific antibody that provides simultaneous dual checkpoint blockade in a single molecule, combined with carboplatin and pemetrexed chemotherapy. As of September 2026 the trial's registry status is active, not recruiting — enrollment has closed and the trial is following enrolled patients toward its survival endpoint.[19][23]
Trial specifications:
- Sponsor: AstraZeneca
- Design: Randomized, open-label, multicenter, global Phase III
- Enrollment: 863 participants (actual count, enrollment closed)[19]
- Experimental arm: Volrustomig + carboplatin/pemetrexed
- Comparator arms: Investigator's choice of platinum-based chemotherapy or nivolumab plus ipilimumab
- Primary endpoint: Overall survival (up to 61 months)
- Eligibility: Unresectable pleural mesothelioma, no prior systemic therapy, all histologies
- Locations: United States (Phoenix AZ, Duarte CA, Aurora CO, Jacksonville FL), Canada, Brazil, China, Europe, Japan
- Principal investigators: Marjorie G. Zauderer MD (Memorial Sloan Kettering); Arnaud Scherpereel MD (Lille University, France)
| Key distinction: Volrustomig provides PD-1 and CTLA-4 blockade in a single molecule, which is mechanistically distinct from separately administered nivolumab plus ipilimumab. Efficacy data are not yet available, and the trial is no longer accepting new patients as of September 2026. |
Atezomeso (NCT04996017) — Currently Recruiting
Atezomeso is a Phase III trial sponsored by the Gruppo Oncologico Italiano di Ricerca Clinica (GOIRC) evaluating adjuvant atezolizumab versus placebo after pleurectomy/decortication in resected malignant pleural mesothelioma.[24]
Trial specifications:
- Sponsor: Gruppo Oncologico Italiano di Ricerca Clinica
- Design: Randomized, Phase III, adjuvant setting
- Enrollment target: 162 patients (estimated)
- Setting: Post-surgical (after pleurectomy/decortication), rather than the post-immunotherapy relapsed setting most other Phase III trials on this page target
- Status: Recruiting as of September 2026[24]
This is currently the only actively recruiting Phase III mesothelioma trial in the ClinicalTrials.gov registry (HIT-Meso is also recruiting but is registered without a drug-development phase, so it does not count toward a Phase III total).
VT3989 Phase III — First TEAD Inhibitor Registrational Trial
VT3989, developed by Vivace Therapeutics, is the most clinically advanced TEAD inhibitor in mesothelioma development. The Phase III registrational trial — acronym sTEADfast, registered as NCT07824986 — was posted to ClinicalTrials.gov on September 17, 2026, making it the first-ever pivotal trial of a targeted therapy specifically designed for relapsed mesothelioma. The trial's status is listed as not yet recruiting, with an estimated start date of December 2026.[7][25][8]
sTEADfast will randomize approximately 350 patients 1:1 to VT3989 (100 mg orally once daily, two-weeks-on/two-weeks-off) versus investigator's choice of gemcitabine or vinorelbine. The trial is restricted to advanced epithelioid pleural mesothelioma that progressed after platinum-based chemotherapy and immunotherapy; sarcomatoid and biphasic histologies, and non-pleural disease at initial diagnosis, are excluded. Overall survival is the primary endpoint, with BICR-assessed progression-free survival as the key secondary endpoint.[8]
Phase I/II results at optimized dose (100 mg, 2-weeks-on/2-weeks-off; n=22):
- Objective response rate: 32% (7 of 22 partial responses)
- Disease control rate: 86% (19 of 22 patients with PR or SD)
- Median progression-free survival: 40 weeks (approximately 10 months) — more than double the approximately 15-week benchmark for standard-of-care in this setting
- Safety: Grade 3-4 treatment-related adverse events in only 8.7% of all 172 treated patients; proteinuria was reversible with dose adjustment
- Tumor types: Activity demonstrated in both NF2-mutant and NF2-wild-type tumors
- FDA designations: Orphan Drug (July 2025) and Fast Track (October 2025) for post-ICI, post-platinum mesothelioma
- Potential approval timeline: 2028-2029
VT3989 became the most clinically advanced TEAD inhibitor after Novartis discontinued IAG933 in October 2025 (13% ORR, dose-limiting QTc prolongation) and Ikena Oncology discontinued IK-930 in May 2024.[7]
HIT-Meso (NCT05655078) — Proton Beam Therapy
HIT-Meso is a UK-only randomized trial evaluating proton beam therapy for mesothelioma, the first randomized trial of this radiation approach in the disease. In the ClinicalTrials.gov registry the trial is recorded with no drug-development phase (phase: NA), which is typical for radiotherapy-only trials rather than drug trials; it is not counted among the page's Phase III drug trials for that reason.[20]
Trial specifications:
- Sponsor: University College London
- Enrollment target: 148 patients
- Experimental arm: Proton beam therapy 50 Gy in 25 fractions with integrated boost to 60 Gy
- Control arm: Active surveillance (deferral of systemic therapy until progression)
- Co-primary endpoints: Progression-free survival and overall survival
- Eligibility: Histologically confirmed MPM; N0/N1 M0 disease; WHO PS 0-1; FEV1 and DLCO at least 40% predicted; no prior thoracic radiation or systemic therapy
- Sites: 18-20 UK NHS centers; proton beam therapy at UCLH (London) and The Christie (Manchester)
- Recruitment window: April 2024 through March 2027
- Note: U.S. patients cannot currently enroll in this trial
ATOMIC-Meso Results — BLA Under FDA Review
The ATOMIC-Meso trial (NCT02709512) has completed enrollment with practice-changing results published in JAMA Oncology in April 2024. Pegargiminase (ADI-PEG20) is an arginine depletion therapy targeting ASS1-deficient tumors, with a particular benefit for non-epithelioid mesothelioma.[13]
Published results (non-epithelioid patients):
- Median overall survival: 9.3 months versus 7.7 months with placebo plus chemotherapy (HR 0.71; p=0.02)
- 36-month survival: 11.9% versus 3.3% with placebo plus chemotherapy
- Population: Non-epithelioid (sarcomatoid and biphasic) pleural mesothelioma
Regulatory status: Polaris Group began a rolling BLA submission on November 16, 2023, and reported in August 2025 that, after FDA completed its filing review, the BLA had entered FDA substantive review.[14] ASCO 2025 guidelines already include a conditional recommendation for pegargiminase plus chemotherapy for non-epithelioid patients who are not candidates for immunotherapy (Recommendation 4.4).[26]
| "The ATOMIC-Meso results represent a breakthrough for patients with non-epithelioid mesothelioma, a subtype that historically had very limited treatment options. Quadrupling three-year survival changes the outlook for these patients and their families. We urge anyone diagnosed with sarcomatoid or biphasic mesothelioma to discuss pegargiminase with their oncologist." |
| — Rod De Llano, Founding Partner, Danziger & De Llano |
Phase III trial comparison:
| Trial | NCT Number | Intervention | Population | Enrollment | Status |
|---|---|---|---|---|---|
| eVOLVE-Meso | NCT06097728 | Volrustomig + chemo | First-line, all histologies | 863 | Active, not recruiting |
| Atezomeso | NCT04996017 | Adjuvant atezolizumab vs. placebo | Post-pleurectomy/decortication | 162 (planned) | Recruiting |
| VT3989 Phase III (sTEADfast) | NCT07824986 | VT3989 vs. gemcitabine/vinorelbine | Post-ICI, post-platinum, epithelioid pleural only | 350 (planned) | Not yet recruiting |
| HIT-Meso | NCT05655078 | Proton beam therapy | Early-stage, UK only | 148 | Recruiting (UK) |
| ATOMIC-Meso | NCT02709512 | Pegargiminase + chemo | Non-epithelioid | 249 (complete) | BLA under FDA review |
What CAR-T Cell Therapy Trials Are Available for Mesothelioma?
CAR-T (Chimeric Antigen Receptor T-cell) therapy represents one of the most promising frontiers in mesothelioma treatment. These engineered immune cells are programmed to recognize and attack cancer cells expressing specific surface proteins. Mesothelin, which is overexpressed in approximately 70-80% of epithelioid mesotheliomas, is the primary target for mesothelioma CAR-T trials.[27] Five CAR-T or cell therapy programs are currently recruiting mesothelioma patients.
Memorial Sloan Kettering Intrapleural CAR-T (NCT04577326)
MSK pioneered the regional delivery of CAR-T cells directly into the pleural space, a method that maximizes tumor contact while minimizing systemic toxicity. The current trial tests M28z1XXPD1DNR, a next-generation CAR-T construct with a built-in dominant-negative PD-1 receptor that eliminates the need for concurrent checkpoint inhibitor therapy.[10][28]
Trial details:
- Principal investigator: Prasad S. Adusumilli MD, Director of the Mesothelioma Program and Head of Solid Tumor Cell Therapy at MSK
- Phase: I dose-escalation
- CAR construct: M28z1XXPD1DNR (mesothelin-targeted with CD28 co-stimulatory domain + dominant-negative PD-1 receptor)
- Delivery: Intrapleural infusion via pleural catheter; minimum 48-hour inpatient monitoring
- Preconditioning: IV cyclophosphamide 1.5 g/m2 administered 2-7 days before infusion
- Eligibility: Epithelioid or biphasic MPM with at least 10% mesothelin expression by immunohistochemistry; at least one prior treatment line
- Location: Memorial Sloan Kettering Cancer Center, New York, NY
| Breakthrough results from predecessor trial (NCT02414269): In 18 patients who received CAR-T cells plus pembrolizumab, the median overall survival from CAR-T infusion was 23.9 months (95% CI 14.7-NE), with an 83% one-year survival rate (95% CI 68-100%). The objective response rate was 72% in the mesothelioma subgroup (n=11), including 2 complete metabolic responses on PET. No on-target/off-tumor toxicity was observed.[10] |
NCI TNhYP218 CAR-T (NCT06885697)
This National Cancer Institute trial evaluates a novel CAR-T construct derived from T naive/stem cell memory cells, providing superior longevity and self-renewal compared to standard T effector memory cells. The hYP218 single-chain variable fragment targets a membrane-proximal region of mesothelin with increased tumor-killing capacity demonstrated in preclinical studies.[17][29]
Trial details:
- Principal investigator: Raffit Hassan MD, Senior Investigator, NCI
- Phase: I dose-escalation with mesothelioma expansion cohort
- Design: 100-patient study; Arm 1 (dose escalation, all mesothelin-expressing solid tumors); Arm 2 (mesothelioma-only expansion at recommended Phase II dose)
- Delivery: Intravenous (systemic infusion) — contrasts with MSK's intrapleural approach
- Preconditioning: 7-day lymphodepletion with fludarabine plus cyclophosphamide
- Monitoring: 14-day inpatient monitoring; 15-year long-term safety follow-up per FDA requirement
- Eligibility: Mesothelin expression in at least 50% of tumor cells; at least one prior treatment; no history of lung fibrosis or serious autoimmune disease
- Location: NIH Clinical Center, Bethesda, Maryland
- Cost: All medical care provided at no cost to participants; some travel expenses may be covered
EVEREST-2 A2B694 (NCT06051695)
The EVEREST-2 trial evaluates A2B694, a logic-gated Tmod CAR-T cell therapy designed to virtually eliminate on-target, off-tumor toxicity. The CAR has two receptors: an activator that recognizes mesothelin on both tumor and normal cells, and a blocker that binds HLA-A*02, preventing activity against cells retaining HLA-A*02. Only tumor cells with HLA-A*02 loss of heterozygosity (LOH) are targeted.[21]
Trial details:
- Sponsor: A2 Biotherapeutics
- Phase: I/II (first patient dosed April 24, 2024)
- Patient selection: Enrollment requires prescreening through BASECAMP-1 (NCT04981119) using next-generation sequencing via Tempus AI to identify HLA-A*02 LOH in tumor tissue — this adds 2-4 weeks to the pre-enrollment timeline
- Eligibility: HLA-A*02 LOH required in tumor; mesothelin-expressing solid tumors; at least one prior treatment
- Sites: Multiple U.S. locations
STAR-101 SynKIR-110 (NCT05568680)
The STAR-101 trial tests SynKIR-110, a KIR-based CAR-T cell therapy developed by Verismo Therapeutics. This multi-chain killer immunoglobulin-like receptor (KIR)-based CAR incorporates NK cell-like signaling, resulting in reduced exhaustion markers and superior serial killing in preclinical mesothelioma models.[30]
Trial details:
- Phase: Phase 1, first-in-human, open-label dose-escalation (3 + 3 design); a single intravenous infusion of SynKIR-110 is given after non-myeloablative lymphodepleting chemotherapy
- Status: Recruiting (ClinicalTrials.gov registry updated June 23, 2026). Estimated enrollment 42 participants; study start March 30, 2023; estimated primary completion December 2027[30]
- FDA designations: Orphan Drug Designation (granted September 28, 2022) and Fast Track Designation (granted April 5, 2023), both for mesothelioma[31]
- Recruiting sites: Moffitt Cancer Center (Tampa, FL), University of Pennsylvania (Philadelphia), MD Anderson Cancer Center (Houston), and University of Wisconsin Carbone Cancer Center
- Active, not recruiting: University of Kansas Cancer Center
- Population: Mesothelin-expressing epithelial mesothelioma (pleural or peritoneal), advanced ovarian, primary peritoneal, or fallopian tube cancer, or cholangiocarcinoma, after at least one prior line of systemic therapy (ECOG 0–1). Sarcomatoid and biphasic mesothelioma are excluded
- Endpoints: Primary outcome is safety and feasibility (treatment-emergent adverse events, cytokine release syndrome and neurologic toxicity); secondary endpoints define the maximum tolerated or feasible dose and a recommended Phase 2 dose
CAR.70 Anti-CD70 CAR-T (NCT05703854)
The CAR.70 trial evaluates a CD70-targeted CAR-T cell therapy for solid tumors including mesothelioma. CD70 is overexpressed in a subset of mesotheliomas and provides an alternative target for patients whose tumors lack sufficient mesothelin expression for other CAR-T programs.[32]
Trial details:
- Phase: I dose-escalation
- Target antigen: CD70 (alternative to mesothelin-targeted approaches)
- Eligibility: Advanced solid tumors with CD70 expression including mesothelioma; at least one prior treatment
- Sites: Multiple U.S. academic cancer centers
For more information about how immunotherapy works in mesothelioma, see Immunotherapy_for_Mesothelioma.
| CAR-T Trial | NCT Number | Target | Delivery | Key Requirement | Cost |
|---|---|---|---|---|---|
| MSK M28z1XXPD1DNR | NCT04577326 | Mesothelin | Intrapleural | MSLN >=10% IHC | Standard |
| NCI TNhYP218 | NCT06885697 | Mesothelin | Intravenous | MSLN >=50% IHC | Free |
| EVEREST-2 A2B694 | NCT06051695 | Mesothelin (Tmod) | Intravenous | HLA-A*02 LOH | Standard |
| STAR-101 SynKIR-110 | NCT05568680 | Mesothelin (KIR-CAR) | Intravenous | MSLN expression | Standard |
| CAR.70 Anti-CD70 | NCT05703854 | CD70 | Intravenous | CD70 expression | Standard |
What Targeted Therapy Trials Show Promise?
Beyond immunotherapy and CAR-T cell therapy, a new generation of targeted therapies is addressing specific molecular vulnerabilities in mesothelioma. These trials exploit genetic alterations such as NF2 mutations (targeting the Hippo/YAP/TEAD pathway), BAP1 loss (affecting chromatin remodeling), and MTAP deletion (creating a metabolic dependency).
VT3989 TEAD Inhibitor — Detailed Data
VT3989 is a first-in-class pan-TEAD palmitoylation inhibitor targeting the YAP/TEAD transcriptional activation pathway. NF2 mutations, present in approximately 40% of malignant pleural mesotheliomas, constitutively activate this pathway. However, VT3989 demonstrated activity in both NF2-mutant and NF2-wild-type tumors, suggesting broader applicability than initially expected.[7]
| Endpoint | Result (n=22, optimized dose) |
|---|---|
| Objective response rate | 32% (7/22 partial responses) |
| Disease control rate | 86% (19/22 PR or SD) |
| Median progression-free survival | 40 weeks (~10 months) |
| Duration of response | 8 patients on treatment >1 year; 1 approaching 2 years |
| Grade 3-4 TRAEs (all patients) | 8.7% (n=172 total treated) |
| Selected Phase III dose | 100 mg once daily, 2-weeks-on/2-weeks-off |
ISM6331 — First AI-Designed Drug for Mesothelioma (NCT06566079)
ISM6331 is a pan-TEAD inhibitor designed using Insilico Medicine's Chemistry42 artificial intelligence platform, making it the first AI-designed drug to enter clinical testing for mesothelioma. The compound reached first-in-human dosing on January 22, 2025, in China — less than five years from AI platform launch to clinical trial, compared to the typical ten to fifteen year drug development timeline.[16]
Key milestones:
- June 2024: FDA Orphan Drug Designation granted
- August 2024: IND clearance received
- January 22, 2025: First patient dosed in China
- 2026: U.S. enrollment expected
- Mechanism: Pan-TEAD inhibitor blocking the palmitoylation site, disrupting YAP/TAZ-TEAD transcriptional activity
ODM-212 — Oral Pan-TEAD Inhibitor With FDA and EU Orphan Designation (NCT06725758)
ODM-212 is an investigational oral pan-TEAD inhibitor developed by Orion Pharma that blocks TEAD auto-palmitoylation to disrupt the YAP/TAZ-TEAD transcriptional program activated by NF2 loss. As of mid-2026 it is in early-phase, first-in-human testing, and no efficacy results in mesothelioma patients have been reported. Its significance to date is regulatory: ODM-212 received orphan designations for mesothelioma from both major regulators within two months.[33]
Key milestones:
- April 20, 2026: U.S. FDA Orphan Drug Designation granted for mesothelioma (7-year U.S. market exclusivity upon approval)
- June 23, 2026: European Commission orphan designation granted on the recommendation of the EMA Committee for Orphan Medicinal Products (up to 10-year EU market exclusivity upon approval)
- Mechanism: Oral pan-TEAD inhibitor blocking TEAD auto-palmitoylation, disrupting YAP/TAZ-TEAD transcriptional activity
- Lead trial: TEADES (NCT06725758) — Phase 1/2 first-in-human, approximately 315 patients planned, U.S. and European sites; primary endpoints are safety and dose-finding
- Combination trial: TEADCO (NCT07563738) — Phase 1/2, includes a mesothelioma arm pairing ODM-212 with ipilimumab plus nivolumab[34]
Orphan designation is a development incentive for rare-disease drugs, not a marketing approval or evidence of efficacy. ODM-212 joins VT3989 and ISM6331 in a widening field of TEAD-targeted agents being tested against the Hippo pathway dependence that characterizes most mesothelioma.
Tazemetostat for BAP1-Loss Mesothelioma (NCT02860286)
Tazemetostat is an EZH2 inhibitor being evaluated in patients with BAP1-deficient mesothelioma. BAP1 loss occurs in 60-80% of mesotheliomas and disrupts chromatin remodeling, creating a vulnerability to EZH2 inhibition. Tazemetostat is already FDA-approved for epithelioid sarcoma (a related BAP1/INI1 alteration), providing a regulatory precedent.[35]
- Status: Enrollment complete; results under analysis; expected in 2026
- Sites: Dana-Farber Cancer Institute, Emory Winship Cancer Institute, and other academic centers
- Eligibility: Relapsed/refractory mesothelioma with BAP1 loss (any anatomic site including peritoneal)
Tulmimetostat/CPI-0209 (NCT04104776)
Tulmimetostat is a next-generation dual EZH2/EZH1 inhibitor with potentially broader chromatin remodeling effects than tazemetostat. Preliminary Phase II results (ASCO 2024, data cutoff October 15, 2023) showed 1 partial response among 29 evaluable patients, meeting Stage 2 expansion eligibility criteria.[36]
- Sponsor: Jazz Pharmaceuticals (formerly Constellation Pharmaceuticals)
- Sites: Emory Winship, University of Chicago, University of Maryland, Massachusetts General Hospital, Dana-Farber
- Population: Cohort M5 — relapsed/refractory malignant pleural or peritoneal mesothelioma with BAP1 loss
MRTX1719 for MTAP-Deleted Mesothelioma (NCT05245500)
MRTX1719 is an MTA-cooperative PRMT5 inhibitor selectively active in MTAP-deleted tumors. MTAP deletion occurs in approximately 25% of mesotheliomas and creates a metabolic vulnerability that MRTX1719 exploits.[37]
- Sponsor: Bristol Myers Squibb (acquired Mirati Therapeutics)
- Phase: I (multiple expansion cohorts)
- Sites: Mayo Clinic (Phoenix, Jacksonville, Rochester), Sarah Cannon Research Institute (Denver, Orlando), Rocky Mountain Cancer Centers
Olaparib for HRD Mesothelioma (NCT04515836)
Olaparib is a PARP inhibitor being studied in mesothelioma patients with homologous recombination deficiency (HRD), including BAP1-loss tumors. BAP1 is involved in the DNA damage repair pathway, and its loss may create a synthetic lethality with PARP inhibition — the same vulnerability exploited by olaparib in BRCA-mutated ovarian and breast cancers.[38]
- Sponsor: University of Chicago
- Phase: II
- Mechanism: PARP inhibition in HRD-positive tumors (including BAP1-loss)
- Eligibility: Mesothelioma with documented homologous recombination deficiency or BAP1 loss; at least one prior treatment
- Sites: University of Chicago Medical Center
Sacituzumab Govitecan (NCT06477419)
Sacituzumab govitecan is an antibody-drug conjugate (ADC) targeting TROP-2, a surface protein expressed on the majority of epithelioid mesotheliomas. ADCs combine the specificity of targeted antibodies with the cell-killing potency of chemotherapy, delivering cytotoxic payloads directly to tumor cells. Sacituzumab govitecan is already FDA-approved for triple-negative breast cancer and urothelial carcinoma.[39]
- Sponsor: Memorial Sloan Kettering Cancer Center
- Phase: II
- Mechanism: TROP-2-targeted antibody-drug conjugate
- Eligibility: Previously treated malignant pleural mesothelioma
- Location: Memorial Sloan Kettering Cancer Center, New York, NY
UV1 Telomerase Vaccine (NIPU Trial Results)
The NIPU Phase II trial (NCT04300244) randomized 118 patients with previously treated mesothelioma to nivolumab plus ipilimumab with or without UV1, an off-the-shelf synthetic peptide vaccine targeting hTERT (expressed in 85-90% of all cancers). No HLA pre-screening is required. UV1 earned FDA Fast Track designation in February 2024.[15][40]
| Endpoint | UV1 + Nivo/Ipi | Nivo/Ipi Alone |
|---|---|---|
| Objective response rate | 31% | 16% |
| Median overall survival | 15.4 months | ~11 months |
| Death risk reduction | 27% (secondary endpoint) | Reference |
TTFields/Optune Lua
TTFields (tumor treating fields), delivered via the Optune Lua device (Novocure), received FDA Humanitarian Device Exemption (HDE) approval on May 23, 2019, for adult patients with unresectable, locally advanced or metastatic pleural mesothelioma used concurrently with pemetrexed plus platinum chemotherapy. The approval was based on the STELLAR trial (NCT02397928).[41]
STELLAR results (80 patients, single-arm Phase II):
- Median OS: 18.2 months (95% CI 12.1-25.8)
- One-year OS: 62.2%
- Median PFS: 7.6 months
- ORR: 40%
- Disease control rate: 97%
Important limitations: STELLAR had no randomized control group and compared results to historical controls from 2003. The FDA's approval statement noted that "effectiveness of this device for this use has not been demonstrated." No Phase III randomized controlled trial of TTFields in mesothelioma has been registered or announced as of April 2026. NCCN (v2.2025) and ASCO 2025 guidelines do not prominently feature TTFields in mesothelioma treatment recommendations, reflecting the absence of Phase III data.[26]
BNT327/PM8002 Bispecific Antibody
BNT327/PM8002 is a PD-L1/VEGF-A bispecific antibody that demonstrated remarkable activity in mesothelioma, with particularly exceptional results in peritoneal mesothelioma.[11][12]
Phase II results (31 patients with unresectable mesothelioma, NCT05918107, completed March 2026):
- Confirmed overall response rate: 51.6%
- Peritoneal mesothelioma cohort (8 patients): 75% ORR, 100% disease control rate
- Median exposure: 16.0 months (95% CI 8.1-19.5)
- Median follow-up: 19.3 months
- Safety: 93.5% experienced grade 3/4 adverse events; no treatment-related deaths
- Phase III trial: None registered for mesothelioma as of September 2026. NCT07133750, sometimes associated with the BNT327/PM8002 name, is a separate Phase II trial in metastatic colorectal cancer and does not involve mesothelioma patients.
| Exceptional peritoneal results: BNT327/PM8002 achieved a 75% objective response rate with 100% disease control in 8 peritoneal mesothelioma patients — among the highest response rates ever reported in this rare subtype, in the completed Phase II study NCT05918107. No mesothelioma Phase III trial has been registered as of September 2026.[11][12] |
What Trials Are Available for Peritoneal Mesothelioma?
Peritoneal mesothelioma accounts for approximately 10-15% of all mesothelioma diagnoses and has a distinct treatment landscape from pleural disease. While cytoreductive surgery (CRS) with heated intraperitoneal chemotherapy (HIPEC) remains the standard of care for eligible patients, several clinical trials now offer additional options.[42]
CRS-HIPEC Outcomes
Cytoreductive surgery with HIPEC remains the gold standard for resectable peritoneal mesothelioma. Published data from specialized centers demonstrate:
- Median overall survival: 53 months (approximately 4.4 years)
- Five-year survival: 47% in selected patients
- Best candidates: Completeness of cytoreduction index (CC-0 or CC-1), epithelioid histology, low peritoneal cancer index[42]
ICARuS II (NCT06057935)
The ICARuS II trial evaluates intraperitoneal chemotherapy following cytoreductive surgery for peritoneal mesothelioma.[43]
- Chemotherapy agents: Pemetrexed, cisplatin, or carboplatin delivered intraperitoneally after CRS
- Sites: University of Chicago, University of Michigan, Washington University (St. Louis), University of Nebraska, Rutgers University
PIPAC with Nab-Paclitaxel (NCT07253662)
Pressurized intraperitoneal aerosol chemotherapy (PIPAC) represents a novel drug delivery method that uses aerosolized chemotherapy delivered under pressure during laparoscopy, allowing for more homogeneous drug distribution across peritoneal surfaces.[44]
- Sponsor: Cedars-Sinai Medical Center
- Phase: I/II
- Drug: Nab-paclitaxel delivered via PIPAC, repeated every 6 weeks
- Location: Cedars-Sinai Medical Center, Los Angeles, California
BNT327/PM8002 Peritoneal Cohort
As noted in the targeted therapy section, BNT327/PM8002 achieved a 75% objective response rate with 100% disease control rate in 8 peritoneal mesothelioma patients — among the most promising results ever reported in this subtype, in the completed Phase II study NCT05918107. No mesothelioma Phase III trial has been registered as of September 2026.[11][12]
Real-World ICI Data for Peritoneal Mesothelioma
A French real-world study (published European Journal of Cancer, December 2025) demonstrated that immune checkpoint inhibitors achieve a median overall survival of 16.8 months in unresectable peritoneal mesothelioma.[45] The ASCO 2025 guidelines have extended immunotherapy recommendations to peritoneal mesothelioma patients who are candidates for systemic therapy, though they acknowledge limited peritoneal-specific trial evidence.[26]
| Important for peritoneal patients: Most major Phase III mesothelioma trials (eVOLVE-Meso, CheckMate 743, KEYNOTE-483) enrolled primarily pleural mesothelioma patients. Peritoneal patients should discuss trial options with a peritoneal mesothelioma specialist, as eligibility and optimal treatment sequencing differ from pleural disease. See Peritoneal_Mesothelioma for more information. |
Am I Eligible for a Mesothelioma Clinical Trial?
Eligibility for mesothelioma clinical trials depends on several factors including disease stage, histological subtype, prior treatments, performance status, organ function, and specific biomarker profiles. Understanding these requirements helps patients and their oncologists identify the most appropriate trials before contacting trial coordinators.[46]
Stage-Specific Eligibility
| Stage | Available Trial Types | Key Considerations |
|---|---|---|
| Stage I-II | Perioperative/neoadjuvant trials (surgery-based); first-line systemic therapy trials; proton beam therapy (HIT-Meso, UK only) | Patients with early-stage disease have the broadest trial options including surgical approaches. The Johns Hopkins perioperative nivolumab plus ipilimumab trial demonstrated 28.6 months median OS in the combination arm.[47] |
| Stage III | Most systemic therapy trials (eVOLVE-Meso, KEYNOTE-483 regimen); potentially perioperative trials at select centers; targeted therapy and immunotherapy combinations | Stage III patients are eligible for the majority of first-line systemic therapy trials. Some perioperative approaches may still be available depending on the extent of disease and surgeon assessment. |
| Stage IV | Systemic therapy only (immunotherapy, targeted therapy, CAR-T); compassionate use possible for late-stage patients | Stage IV patients are generally limited to systemic approaches. Compassionate use or expanded access programs may be available for patients who do not meet standard trial criteria. Contact the trial sponsor directly to inquire. |
For detailed staging information, see Mesothelioma_Diagnosis_and_Staging.
General Laboratory and Performance Requirements
Most mesothelioma clinical trials require patients to meet baseline laboratory values and performance criteria. The following thresholds are representative of Phase II and Phase III trial requirements:[46]
| Requirement | Typical Standard | Notes |
|---|---|---|
| ECOG performance status | 0-1 (some Phase I trials accept 2) | See ECOG table below |
| Absolute neutrophil count (ANC) | >=1,500/uL | Recent CBC required |
| Platelet count | >=100,000/uL | Recent CBC required |
| Hemoglobin | >=9.0 g/dL | Some trials accept >=8.0 g/dL |
| Creatinine clearance | >=45 mL/min | Calculated by Cockcroft-Gault formula |
| Total bilirubin | <=1.5x upper limit of normal (ULN) | Recent chemistry panel required |
| ALT/AST | <=5x ULN | Liver function assessment |
| Life expectancy | >=12 weeks (Phase II/III) | Some Phase I trials accept >=4 weeks |
ECOG Performance Status
| ECOG Grade | Description | Trial Eligibility |
|---|---|---|
| 0 | Fully active; no restrictions on pre-disease activities | Eligible for virtually all trials |
| 1 | Restricted in strenuous activity but ambulatory; able to carry out light work | Eligible for most trials including Phase III |
| 2 | Ambulatory; all self-care; unable to work; up >50% of waking hours | Some Phase I trials and supportive care studies accept PS2 |
| 3 | Limited self-care; confined to bed/chair >50% of waking hours | Generally excluded from interventional trials |
| 4 | Completely disabled; no self-care | Excluded from essentially all interventional trials |
Histology-Specific Eligibility
| Histology | Eligible Trials | Key Exclusions |
|---|---|---|
| Epithelioid | Broadest options: eVOLVE-Meso, all ICI trials, VT3989, BAP1-targeted trials, CAR-T (if mesothelin >=10%), UV1 vaccine, BNT327 | ATOMIC-Meso (non-epithelioid specific) |
| Sarcomatoid | ATOMIC-Meso (pegargiminase), VT3989, MRTX1719 (if MTAP-deleted), some ICI trials | CAR-T trials (sarcomatoid tumors typically do not express mesothelin) |
| Biphasic | Most systemic therapy trials; CAR-T (if mesothelin >=10%); ATOMIC-Meso (non-epithelioid); VT3989 | Some trials may specify histology; check individual protocol |
| Peritoneal | Tazemetostat (includes all sites); tulmimetostat Cohort M5 (includes peritoneal); HIPEC/CRS trials; PIPAC; BNT327 | Most Phase III ICI trials enrolled primarily pleural patients |
Biomarker Requirements
Molecular profiling through next-generation sequencing (NGS) is increasingly critical for determining targeted therapy trial eligibility. Patients should request comprehensive biomarker testing before exploring targeted therapy trials.[26]
| Biomarker | Prevalence in MPM | Testing Method | Required For |
|---|---|---|---|
| BAP1 loss | 60-80% | IHC or NGS | Tazemetostat, tulmimetostat Cohort M5, olaparib HRD trial |
| MTAP deletion | ~25% | NGS | MRTX1719 |
| Mesothelin expression | 70-80% (epithelioid) | IHC (>=10% for MSK; >=50% for NCI) | All CAR-T trials |
| NF2 mutation | 30-50% | NGS | VT3989 (not required but enriches population) |
| ASS1 deficiency | Common in non-epithelioid | IHC | Pegargiminase/ATOMIC-Meso |
| HLA-A*02 LOH | ~30-40% of HLA-A*02+ patients | NGS via BASECAMP-1 | EVEREST-2 A2B694 CAR-T |
ASCO 2025 guideline note: PD-L1, TMB, and MSI status should NOT be used to determine choice of chemotherapy versus immunotherapy in malignant pleural mesothelioma (Recommendation 3.5.3). ASCO's 2025 guideline update, Recommendation 7.1, states that all patients with mesothelioma should be offered germline testing (evidence quality High; strength of recommendation Strong).[26] The European BAP1-TPDS consensus advises that germline BAP1 testing "should not routinely be offered" in isolated mesothelioma, while allowing it to be considered on age of onset and factors such as absence of asbestos exposure (95% consensus, Moderate /weak), and recording at 81% and rated Strong that "the prevalence of germline BAP1 pathogenic variants in individuals with isolated mesothelioma is low (less than 3%)".[48] A germline variant does not displace asbestos as the cause of a carrier's mesothelioma.
Prior Treatment Requirements by Trial Type
| Trial Category | Prior Treatment Requirement |
|---|---|
| First-line trials (eVOLVE-Meso) | Treatment-naive (no prior systemic therapy for MPM) |
| Second-line immunotherapy trials (NIPU/UV1) | At least 1 prior platinum-based chemotherapy regimen |
| CAR-T trials (all four programs) | At least 1 prior treatment regimen; no prior CAR-T therapy |
| VT3989 TEAD inhibitor | At least 1 prior ICI AND at least 1 prior platinum-based therapy (post-ICI, post-platinum) |
| EZH2 inhibitor trials (tazemetostat, tulmimetostat) | At least 1 prior treatment; relapsed/refractory disease |
| Phase I dose-escalation (MRTX1719, ISM6331) | Variable; typically at least 1 prior regimen; confirm by individual protocol |
| Important: Eligibility requirements vary significantly between trials. A patient who does not qualify for one trial may be eligible for others. Work with a mesothelioma specialist to identify all available options. Pre-screening is free and does not obligate enrollment. |
How Do I Find and Enroll in a Mesothelioma Clinical Trial?
The clinical trial enrollment process typically follows seven stages, from initial consultation through treatment initiation. Understanding each step helps reduce delays and increases the likelihood of successful enrollment.[22]
Step 1: Confirm Your Diagnosis and Staging
Gather your complete medical records including your pathology report (with histological subtype — epithelioid, sarcomatoid, or biphasic), all imaging reports (CT, PET, MRI), laboratory work, and any molecular profiling results (BAP1, MTAP, mesothelin expression, NF2 status). Trial coordinators will need these documents to assess eligibility. For more information, see Mesothelioma_Diagnosis_and_Staging.[46]
Step 2: Ask Your Oncologist About Trial Eligibility
Even if your oncologist does not mention clinical trials, you can ask proactively. Key questions include:
- "Are there any Phase I-III trials I might be eligible for based on my pathology and ECOG status?"
- "Do you know my BAP1, MTAP, and mesothelin status? Do I need biomarker testing to access targeted trials?"
- "Can you refer me to an NCI-designated cancer center for a second opinion and trial evaluation?"
- "Which trials in my area are actively enrolling right now?"
- "What is the expected treatment burden — travel, visits, and time commitments?"
Step 3: Search ClinicalTrials.gov
Navigate to ClinicalTrials.gov and follow these steps:[49]
- Enter search terms: "mesothelioma" OR "malignant pleural mesothelioma" OR "peritoneal mesothelioma" (depending on your diagnosis)
- Apply filters: Status = Recruiting only; Phase = Phase 2 and Phase 3 for trials closest to FDA approval; Location = your city/state with 100-300 mile radius
- Review key fields for each result: status (must say "Recruiting"), primary completion date (should be in the future), eligibility criteria (review both inclusion and exclusion lists)
- Note the unique NCT number for each trial and share it with your oncologist
Step 4: Contact the Trial Coordinator
Each trial listing on ClinicalTrials.gov includes contact information for the trial site coordinator. Call or email to discuss your case. The coordinator will conduct an initial telephone review of your medical history against the inclusion/exclusion criteria.[46]
Step 5: Pre-Screening Phone Call
The trial site coordinator reviews your medical records against eligibility criteria. This may require submission of pathology slides or tumor blocks for biomarker testing. Pre-screening is free and does not obligate enrollment. Some trials (such as EVEREST-2/A2B694) require a separate prescreening study that adds 2-4 weeks.[21]
Step 6: In-Person Screening Visit (Baseline Assessments)
Complete baseline assessments including bloodwork, imaging (CT/PET/MRI), performance status assessment (ECOG scoring), cardiac evaluation, and any protocol-required tests. The baseline period typically takes one to two weeks.[22]
Step 7: Informed Consent and Enrollment
Read the full informed consent document carefully. Ask questions about risks, benefits, alternative treatments, and your right to withdraw at any time without penalty to your care. Once you sign informed consent, you begin treatment according to the assigned protocol with regular study visits and monitoring.[22]
Trial Search Resources
| Resource | URL | Key Features |
|---|---|---|
| ClinicalTrials.gov | clinicaltrials.gov | Authoritative U.S. federal registry; legally required listing for all U.S. trials[49] |
| NCI Cancer.gov Trial Finder | cancer.gov | Patient-friendly interface; 12,000+ trials; NCI-sponsored trial detail[29] |
What Financial Assistance Is Available for Trial Participants?
Understanding the financial landscape of clinical trial participation helps patients make informed decisions about enrollment. Federal law protects patients from many trial-related costs, and multiple assistance programs exist specifically for mesothelioma patients.[50]
What Trials Cover Versus What Patients Pay
| Cost Category | Covered By | Examples |
|---|---|---|
| Research costs | Trial sponsor (pharmaceutical company, NIH, university) | Experimental drug; extra protocol-required tests; data collection activities; additional study procedures |
| Routine patient care | Patient's health insurance | Standard drugs and procedures; medical care for administering treatment; care for trial-related complications; standard lab work and imaging |
| Travel and lodging | Not typically covered by insurance; may be covered by sponsor programs or patient assistance organizations | Transportation; hotel stays; meals during visits |
Key principle: Patients should never have to pay for the experimental drug itself — this is always covered by the trial sponsor.[50]
Insurance Protections
Affordable Care Act (ACA): The ACA requires most private health insurance plans and Marketplace plans to cover routine patient care costs associated with qualifying clinical trials. Insurers cannot deny participation, limit coverage, or charge more because a patient enrolls in a trial. Most Phase II and III mesothelioma trials registered on ClinicalTrials.gov qualify under these protections.[51]
Medicare: Medicare Parts A and B cover routine care costs in qualifying clinical trials. Part A covers inpatient hospital stays required by trial participation, and Part B covers outpatient care, doctor visits, and standard chemotherapy in clinical settings. Patients typically pay approximately 20% of approved costs after meeting the Part B deductible. Medicare does not cover research costs — these are covered by the sponsor.[52]
Private insurance: Forty-four states have enacted laws mandating clinical trial cost coverage. Contact your insurer before enrollment to verify coverage specifics.[50]
Medicaid: Since January 1, 2022, federal law has required state Medicaid programs to cover routine patient costs for beneficiaries enrolled in qualifying clinical trials.[53] Contact your state Medicaid office before enrolling to confirm how your plan handles trial-related care.
VA benefits: Veterans enrolled in VA healthcare can participate in clinical trials and receive routine care through the VA system. The VA covers standard medical costs associated with trial participation for eligible veterans.[54]
Travel and Financial Assistance Programs
| Program | Description | Contact |
|---|---|---|
| NCI/NIH Free Care | TNhYP218 CAR-T trial (NCT06885697) provides all medical care at no cost; some travel and lodging may be covered | clinicalcenter.nih.gov |
| Merck Patient Assistance (Keytruda) | Access to pembrolizumab for eligible uninsured or underinsured patients | merckaccessprogram-keytruda.com |
| BMS Patient Assistance (Opdivo/Yervoy) | Access to nivolumab and ipilimumab for eligible patients | bmspaf.org |
What Results Are Expected From Mesothelioma Trials in 2026?
The mesothelioma clinical trial landscape continues to expand in 2026, with several landmark trials opening and key regulatory decisions anticipated.[1]
NCI Neoadjuvant Triplet + Surgery: Phase I Feasibility Results (NCT03228537)
The NCI Neoadjuvant Triplet Trial (NCT03228537) was a Phase I feasibility study sponsored by the National Cancer Institute that tested whether a trimodality regimen — neoadjuvant immunotherapy plus chemotherapy, followed by surgery, followed by maintenance immunotherapy — could be safely delivered to patients with resectable malignant pleural mesothelioma. Twenty-eight patients with Stage I–III epithelioid or biphasic disease received four 21-day cycles of atezolizumab, cisplatin, and pemetrexed before surgery (extrapleural pneumonectomy or pleurectomy/decortication, with radiotherapy following extrapleural pneumonectomy), then up to one year of maintenance atezolizumab.[55]
The trial met its feasibility endpoint: 15 of 28 participants (53.6%) completed therapy from neoadjuvant treatment through at least one maintenance dose. One participant experienced a Grade 4–5 immune-related adverse event. Because the protocol had pre-specified a safety threshold of zero Grade 4–5 immune-related adverse events, this single event meant the safety criterion, as defined, was not met — an important distinction when weighing the regimen's tolerability.
Participant flow narrowed at each stage. Of the 28 enrolled, 21 completed neoadjuvant therapy and 19 proceeded to surgery; 15 began maintenance. The most common reasons for discontinuing before surgery were disease progression (4 patients) and adverse events (2 patients).
Among efficacy measures, median progression-free survival was 9.5 months by RECIST 1.1 and 18.4 months by the pleural-modified mRECIST criteria; median overall survival reached 31.5 months. The objective response rate was 25.0% (7 of 28) by RECIST 1.1 and 35.7% (10 of 28) by mRECIST.[55]
As a single-arm feasibility trial of 28 patients, these results establish that the neoadjuvant-immunotherapy-plus-surgery sequence is deliverable in resectable mesothelioma — not that it is superior to existing approaches. The findings add to a small but growing evidence base for perioperative PD-L1 inhibition in operable malignant pleural mesothelioma, a question larger trials will need to settle.
New Trial Openings
VT3989 Phase III, sTEADfast (NCT07824986, posted September 2026): The first-ever registrational Phase III trial of a targeted therapy for mesothelioma. VT3989 will be tested against investigator's-choice chemotherapy in the post-ICI, post-platinum, epithelioid-pleural-only setting where 32% objective response rate was demonstrated in Phase I/II. The trial is not yet recruiting; an estimated 350 patients will be enrolled beginning around December 2026. If the trial meets its primary endpoint, FDA approval could follow in 2028-2029.[7][8]
BNT327/PM8002 Phase III — not yet registered: The PD-L1/VEGF-A bispecific antibody achieved a 51.6% overall response rate in its completed Phase II mesothelioma study (NCT05918107). No Phase III trial in mesothelioma has been registered as of September 2026. (NCT07133750, occasionally associated with the BNT327/PM8002 name in secondary coverage, is a Phase II trial in metastatic colorectal cancer and is unrelated to mesothelioma.)[11][12]
ISM6331 U.S. enrollment: Following initial enrollment in China beginning January 2025, the AI-designed TEAD inhibitor is expected to begin enrolling U.S. patients in 2026.[16]
MVdeltaC measles-based immunotherapy: A novel oncolytic measles virus platform received FDA Orphan Drug Designation in June 2025 for mesothelioma. Early-phase trials are anticipated at Mayo Clinic sites.[56]
Key Regulatory and Data Milestones
Pegargiminase FDA decision: The BLA for pegargiminase, based on the ATOMIC-Meso results, entered FDA substantive review in August 2025.[14]
Tazemetostat results (expected 2026): Results from the Phase II trial (NCT02860286) of tazemetostat in BAP1-deficient mesothelioma are expected, which will define the future role of EZH2 inhibition in this molecular subgroup.[35]
Antibody-drug conjugates: Several ADC programs are advancing including sacituzumab govitecan (NCT06477419, TROP-2 targeted, Memorial Sloan Kettering) and rinatabart sesutecan.[39]
eVOLVE-Meso readout: eVOLVE-Meso enrolled 863 participants, and the registry gives an estimated primary completion date of November 16, 2028. No efficacy results have been reported. If volrustomig plus chemotherapy demonstrates superiority over the investigator's-choice comparator arm, it could establish a new first-line standard of care.[19]
Recent Phase III Results for Context
Two recently completed Phase III trials provide important context for the evolving treatment landscape:
DREAM3R (NCT04334759): This Phase III trial of durvalumab plus chemotherapy versus chemotherapy alone was stopped early due to slow accrual. Primary results presented at the 2025 ESMO Congress showed median overall survival of 21 versus 18 months (HR 0.92, 95% CI 0.63-1.36; stratified log-rank p=0.9, not statistically significant). However, the objective response rate was significantly higher: 58% versus 35% (p=0.005).[57][58]
BEAT-meso (NCT03762018): The Phase III trial of bevacizumab plus atezolizumab plus chemotherapy published results in 2025. The primary endpoint of overall survival was not met (20.5 versus 18.1 months, HR 0.84, p=0.14), though progression-free survival was statistically significant (9.2 versus 7.6 months, HR 0.72, p<0.01).[59]
These results underscore the difficulty of improving upon current immunotherapy-chemotherapy combinations and highlight why novel approaches such as VT3989, BNT327, and CAR-T cell therapy are generating significant interest.
Completed Early-Phase Readout: Intrapleural RSO-021 (NCT05278975)
Not every 2026 readout comes from a Phase III program. MITOPE (NCT05278975) was a Phase 1/2 study of RSO-021, a thiostrepton formulation that inhibits peroxiredoxin 3, a mitochondrial antioxidant enzyme. The drug was infused directly into the pleural space rather than given intravenously, in patients with malignant pleural effusion from advanced solid tumors including mesothelioma. In the Phase 1 portion, weekly intrapleural RSO-021 at 90 mg was well tolerated in patients with relapsed pleural mesothelioma and was associated with disease control in 67% of patients at 12 weeks.[60] The trial enrolled 50 participants across ten United Kingdom sites, sponsored by RS Oncology LLC, with an actual primary completion date of 2025-11-30; its registry record is listed as Completed.[61]
RSO-021 matters to the trial landscape for a reason distinct from its results: it targets mitochondrial redox balance rather than an immune checkpoint or a growth-signaling pathway, which places it outside the mechanism classes that dominate current mesothelioma research. It remains investigational and is not an approved treatment. The dedicated RSO-021 and PRDX3 inhibition page covers the mechanism and trial design in full.
| Event | Expected Timing | Significance |
|---|---|---|
| VT3989 Phase III (sTEADfast) enrollment begins | ~December 2026 (est.); posted Sep 2026, not yet recruiting | First targeted therapy Phase III in mesothelioma |
| BNT327 mesothelioma Phase III | Not yet registered (as of Sep 2026) | Bispecific antibody with 51.6% ORR in completed Phase II (NCT05918107) |
| ISM6331 U.S. enrollment | 2026 | First AI-designed mesothelioma drug in U.S. patients |
| Pegargiminase FDA decision | Pending | BLA in FDA substantive review since August 2025[14] |
| Tazemetostat Phase II results | 2026 | EZH2 inhibition in BAP1-loss mesothelioma |
| MVdeltaC early trials | 2026 | Oncolytic virus approach with FDA Orphan Drug status |
| eVOLVE-Meso primary completion (registry estimate) | November 2028 | Potential new first-line standard of care if positive |
What Are the Latest FDA-Approved Treatments from Clinical Trials?
Every currently approved systemic treatment for malignant pleural mesothelioma was established through clinical trials. The following timeline documents the four major regulatory approvals and the trials that enabled them.[5][2][3][41]
| Year | Treatment | Pivotal Trial | Key Results | Approval Type |
|---|---|---|---|---|
| 2004 | Cisplatin + pemetrexed | EMPHACIS (Vogelzang 2003) | Median OS 12.1 vs. 9.3 months; first systemic therapy for MPM[2] | Full FDA approval |
| May 2019 | TTFields/Optune Lua | STELLAR (Ceresoli 2019) | Median OS 18.2 months; 62.2% one-year OS; single-arm, no RCT control[41] | HDE only (H180002) |
| October 2020 | Nivolumab + ipilimumab | CheckMate 743 (Baas 2021)[3] | Median OS 18.1 vs. 14.1 months (HR 0.74); non-epithelioid five-year OS 12% vs. 1% (HR 0.48; 95% CI 0.33–0.68)[62] | Full FDA approval |
| September 2024 | Pembrolizumab + pemetrexed + platinum | KEYNOTE-483 / IND.227 | Median OS 17.3 vs. 16.1 months (HR 0.79); 52% vs. 29% confirmed ORR; non-epithelioid HR 0.57 | Full FDA approval[4][5] |
CheckMate 743 Five-Year Update (February 2026)
The five-year update of CheckMate 743, published by Scherpereel et al. in the Journal of Clinical Oncology in February 2026, represents the longest follow-up data ever reported for first-line immunotherapy in pleural mesothelioma (median follow-up 66.8 months).[6]
| Endpoint | Nivolumab + Ipilimumab | Chemotherapy | HR (95% CI) |
|---|---|---|---|
| Median OS | 18.1 months | 14.1 months | 0.74 (0.62-0.88) |
| Five-year OS | 14% | 6% | — |
| Epithelioid five-year OS | 14% | 8% | 0.85 (0.69-1.03) |
| Non-epithelioid five-year OS | 12% | 1% | 0.48 (0.33-0.68) |
| Five-year PFS | 8% | 0% | — |
| Responders with ongoing response at 5 years | 17% | 0% | — |
The five-year data confirm that nivolumab plus ipilimumab provides the most durable survival benefit of any first-line regimen in mesothelioma. In non-epithelioid disease, 12% of immunotherapy-treated patients were alive at five years compared to just 1% receiving chemotherapy — establishing dual immunotherapy as the unequivocal standard of care for sarcomatoid and biphasic histologies. For detailed immunotherapy information, see Immunotherapy_for_Mesothelioma.[6]
KEYNOTE-483 Key Results
The KEYNOTE-483 trial (N=440, Phase III component) established pembrolizumab plus chemotherapy as a new first-line standard for pleural mesothelioma:[4][5]
- Median OS: 17.3 months versus 16.1 months (HR 0.79, 95% CI 0.64-0.98; p=0.0324)
- Three-year OS: 25% versus 17%
- ORR (per posted registry results): 62.2% (138/222) versus 38.1% (83/218)[9]
- Non-epithelioid median OS: 12.3 months versus 8.2 months (HR 0.57, 95% CI 0.36-0.89)
September 2025 update: The FDA approved Keytruda QLEX (subcutaneous pembrolizumab and berahyaluronidase alfa-pmph) on September 19, 2025, offering a one-minute injection every three weeks as an alternative to IV infusion for all 38 solid tumor indications approved for pembrolizumab including mesothelioma.[63]
| "Clinical trials represent the cutting edge of mesothelioma treatment. We encourage every patient to explore trial options because tomorrow's standard treatments are available today through these programs. The survival improvements we are seeing — 14% alive at five years with immunotherapy, 83% one-year survival with CAR-T cells, 32% response rates with TEAD inhibitors — were unimaginable just a decade ago." |
| — Paul Danziger, Founding Partner, Danziger & De Llano |
|
Free, Confidential Case Evaluation Call (855) 699-5441 or visit dandell.com/contact-us No upfront fees • Experienced representation • National practice |
Frequently Asked Questions
What clinical trials are available for Stage 3 mesothelioma patients?
Stage III mesothelioma patients are eligible for the majority of first-line systemic therapy trials, including the eVOLVE-Meso Phase III trial (NCT06097728) evaluating volrustomig plus chemotherapy. Stage III patients may also qualify for second-line trials such as VT3989 after initial treatment, all four active CAR-T programs (if they meet mesothelin expression thresholds), and targeted therapy trials based on their molecular profile. While most surgical perioperative trials target earlier-stage disease, some centers evaluate Stage III patients on a case-by-case basis depending on the extent of tumor involvement.[19][46]
Can mesothelioma patients with prior chemotherapy qualify for clinical trials?
Yes. Many clinical trials specifically require prior chemotherapy as an eligibility criterion. All four CAR-T trials require at least one prior treatment line, VT3989 requires both prior immunotherapy and prior platinum-based chemotherapy, and EZH2 inhibitor trials (tazemetostat, tulmimetostat) require relapsed or refractory disease. First-line trials such as eVOLVE-Meso require treatment-naive patients, but the majority of Phase I and Phase II trials accept previously treated patients. Having received prior chemotherapy expands rather than limits trial options in the second-line and beyond settings.[46][25]
What is the VT3989 clinical trial for mesothelioma?
VT3989 is a first-in-class TEAD inhibitor developed by Vivace Therapeutics that targets the Hippo/YAP/TEAD pathway, which is dysregulated in the majority of mesotheliomas. In Phase I/II testing at the optimized dose (100 mg, two-weeks-on/two-weeks-off) in 22 mesothelioma patients, VT3989 achieved a 32% objective response rate, 86% disease control rate, and approximately 10-month median progression-free survival. The drug holds FDA Orphan Drug and Fast Track designations. The Phase III registrational trial, sTEADfast (NCT07824986), was posted September 17, 2026 and is not yet recruiting; it will compare VT3989 to investigator's choice chemotherapy in patients with epithelioid pleural mesothelioma who have progressed after immunotherapy and platinum-based chemotherapy, with potential FDA approval in 2028-2029.[7][8]
How long does it take to get into a mesothelioma clinical trial?
The enrollment timeline from initial interest to first treatment typically ranges from two to six weeks. The process includes gathering medical records (one to two days), pre-screening phone consultation with the trial coordinator (one to three days), submission of pathology and imaging for review (one to two weeks), in-person screening visit with baseline assessments (one to two weeks), and informed consent review and enrollment. Some trials add additional steps: EVEREST-2 requires prescreening through BASECAMP-1, which adds two to four weeks for HLA-A*02 LOH testing. Patients should begin exploring trials as early as possible after diagnosis to maximize their treatment window.[46]
What is the ISM6331 AI-designed drug for mesothelioma?
ISM6331 is a pan-TEAD inhibitor created using Insilico Medicine's Chemistry42 artificial intelligence platform, making it the first AI-designed drug to enter clinical testing for mesothelioma. The compound received FDA Orphan Drug Designation in June 2024 and IND clearance in August 2024. The first patient was dosed on January 22, 2025, in China, with U.S. enrollment expected in 2026. Notably, ISM6331 progressed from AI platform launch to first-in-human dosing in under five years, compared to the typical ten to fifteen year drug development timeline, demonstrating the potential of AI-accelerated drug design in rare cancers.[16]
Can I participate in a clinical trial if I have already had surgery?
Yes. Prior surgery does not automatically disqualify patients from clinical trials. Most systemic therapy trials (immunotherapy, targeted therapy, CAR-T) accept patients who have undergone prior surgical resection. In fact, some trials specifically target the post-surgical setting: the Johns Hopkins perioperative nivolumab plus ipilimumab trial evaluates immunotherapy both before and after surgery. The key factors are whether the patient has measurable disease remaining (required for most response-based trials), adequate performance status (ECOG 0-1), and sufficient recovery from surgical complications. Patients should discuss their surgical history with the trial coordinator during pre-screening.[47][46]
What happens to my treatment if the clinical trial is discontinued?
If a clinical trial is discontinued, the trial sponsor is obligated to ensure a safe transition for enrolled patients. Options typically include: transition to the standard-of-care treatment, continued access to the experimental drug through a compassionate use or expanded access program (if the drug showed individual benefit), referral to alternative clinical trials, or enrollment in the sponsor's long-term safety follow-up. The informed consent document details these provisions before enrollment begins. Patients retain the right to receive ongoing medical care regardless of trial status, and discontinuation of a trial does not mean the treatment was ineffective for all participants.[22]
Are there clinical trials for peritoneal mesothelioma?
Yes. Several trials are specifically designed for or include peritoneal mesothelioma patients. The ICARuS II trial (NCT06057935) evaluates intraperitoneal chemotherapy after cytoreductive surgery at five U.S. academic centers. The PIPAC trial (NCT07253662) at Cedars-Sinai tests aerosolized intraperitoneal chemotherapy. BNT327/PM8002 achieved a remarkable 75% objective response rate in 8 peritoneal patients in its completed Phase II study (NCT05918107); no mesothelioma Phase III trial has been registered as of September 2026. Tazemetostat (NCT02860286) and tulmimetostat (NCT04104776) both include peritoneal mesothelioma patients. CRS-HIPEC at specialized centers achieves median overall survival of 53 months with 47% five-year survival in selected patients.[11][43][42]
What is the STELLAR trial for mesothelioma?
The STELLAR trial (NCT02397928) was a Phase II, single-arm study that evaluated tumor treating fields (TTFields) using the Optune Lua device in combination with pemetrexed plus platinum chemotherapy in 80 patients with unresectable malignant pleural mesothelioma across 12 European sites. Results showed median overall survival of 18.2 months, 62.2% one-year survival, and a 97% disease control rate. The FDA granted Humanitarian Device Exemption approval in May 2019 based on these results. However, the trial had no randomized control group and was compared to 2003 historical data. No Phase III randomized controlled trial has been registered as of 2026, and major guidelines (ASCO 2025, NCCN v2.2025) do not prominently feature TTFields based on the absence of Phase III data.[41][26]
How does tumor treating fields (TTFields) work in mesothelioma trials?
TTFields deliver low-intensity, intermediate-frequency alternating electric fields to the tumor region through adhesive electrode arrays (transducer arrays) placed on the patient's torso. These electric fields disrupt cell division by interfering with the mitotic spindle and cell membrane integrity in rapidly dividing cancer cells, while sparing normal cells that divide more slowly. In the STELLAR trial, patients wore the device for a median of 16.3 hours per day. The treatment is continuous and portable, allowing patients to maintain daily activities during treatment. Real-world compliance averages approximately 12.5 hours per day, and device cost is approximately $21,000 per month, with inconsistent Medicare and private insurance coverage for the mesothelioma HDE indication.[41]
What is eVOLVE-Meso and who qualifies?
eVOLVE-Meso (NCT06097728) is a Phase III trial sponsored by AstraZeneca. It evaluates volrustomig (MEDI5752), a bispecific antibody that simultaneously blocks PD-1 and CTLA-4 in a single molecule, combined with carboplatin and pemetrexed chemotherapy, and enrolled 863 participants at sites in 21 countries, including the United States, Canada, Brazil, China, Japan and several European countries. As of September 2026 the trial's registry status is active, not recruiting — enrollment is complete and it is no longer accepting new patients. When it was enrolling, eligibility required unresectable malignant pleural mesothelioma with no prior systemic therapy, adequate organ function (ECOG 0-1), and histologically confirmed disease of any subtype. No efficacy data are available yet.[19][23]
Can veterans access mesothelioma clinical trials through the VA?
Yes. Veterans enrolled in VA healthcare can participate in clinical trials and receive routine care through the VA system. The VA covers standard medical costs associated with trial participation for eligible veterans. Additionally, the NCI's TNhYP218 CAR-T trial (NCT06885697) at the NIH Clinical Center in Bethesda, Maryland, provides all medical care at no cost and covers some travel expenses, making it particularly accessible for veterans. Veterans with service-connected mesothelioma receive 100% disability rating and associated benefits. The VA Cooperative Studies Program also sponsors clinical research, and VA hospitals at locations including Houston, Boston, and Los Angeles serve as sites for mesothelioma trials. Veterans should contact their VA oncologist or the Veterans Health Administration to discuss trial options.[17][54]
NCT Verification Table
The following table lists all NCT numbers referenced in this article with their trial name and registry status. Status entries were verified in April 2026, except where a later verification date is stated — the VT3989 Phase III row and NCT07824986 row below were verified September 17, 2026.[49]
| NCT Number | Trial Name | Category | Status |
|---|---|---|---|
| NCT06097728 | eVOLVE-Meso (Volrustomig) | Immunotherapy Phase III | Active, not recruiting (verified Sep 17, 2026) |
| NCT04996017 | Atezomeso (Adjuvant Atezolizumab) | Immunotherapy Phase III | Recruiting (verified Sep 17, 2026) |
| NCT04665206 | VT3989 (TEAD Inhibitor, Phase I/II) | Targeted Therapy Phase I/II | Recruiting |
| NCT07824986 | VT3989 Phase III (sTEADfast) | Targeted Therapy Phase III | Not yet recruiting (posted Sep 17, 2026) |
| NCT05655078 | HIT-Meso (Proton Beam Therapy) | Radiation, randomized (registry phase: NA) | Recruiting (UK only) |
| NCT02709512 | ATOMIC-Meso (Pegargiminase) | Targeted Therapy Phase II/III | Completed; BLA under FDA review |
| NCT04577326 | MSK Intrapleural CAR-T (M28z1XXPD1DNR) | CAR-T Phase I | Recruiting |
| NCT06885697 | NCI TNhYP218 CAR-T | CAR-T Phase I | Recruiting (FREE) |
| NCT06051695 | EVEREST-2 A2B694 (Logic-gated Tmod) | CAR-T Phase I/II | Recruiting |
| NCT05568680 | STAR-101 SynKIR-110 (KIR-CAR) | CAR-T Phase I | Recruiting |
| NCT06566079 | ISM6331 (AI-Designed TEAD Inhibitor) | Targeted Therapy Phase I | Recruiting |
| NCT02860286 | Tazemetostat (EZH2 Inhibitor) | Targeted Therapy Phase II | Enrollment complete |
| NCT04104776 | Tulmimetostat/CPI-0209 | Targeted Therapy Phase I/II | Recruiting |
| NCT05245500 | MRTX1719 (PRMT5 Inhibitor) | Targeted Therapy Phase I | Recruiting |
| NCT04300244 | NIPU (UV1 Vaccine + Nivo/Ipi) | Cancer Vaccine Phase II | Enrollment complete; Phase III planning |
| NCT06057935 | ICARuS II (HIPEC for Peritoneal) | Surgical Phase II | Recruiting |
| NCT07253662 | PIPAC with Nab-Paclitaxel | Surgical Phase I/II | Recruiting |
| NCT05918107 | BNT327/PM8002 (Bispecific Antibody, Phase II) | Bispecific Antibody Phase II | Completed (primary completion March 2026); no mesothelioma Phase III registered |
| NCT02899299 | CheckMate 743 (Nivo + Ipi) | Immunotherapy Phase III | Enrollment complete; 5-year data published Feb 2026 |
| NCT02784171 | KEYNOTE-483 / IND.227 | Immunotherapy Phase II/III | FDA-approved September 2024 |
| NCT02397928 | STELLAR (TTFields) | Device Phase II | Completed; HDE approved May 2019 |
| NCT06477419 | Sacituzumab Govitecan (TROP-2 ADC) | ADC Phase II | Recruiting |
| NCT04981119 | BASECAMP-1 (EVEREST-2 Prescreening) | Prescreening Registry | Recruiting |
| NCT05703854 | CAR.70 Anti-CD70 CAR-T | CAR-T Phase I | Recruiting |
| NCT04515836 | Olaparib (PARP Inhibitor for HRD) | Targeted Therapy Phase II | Recruiting |
| NCT04334759 | DREAM3R (Durvalumab + Chemo) | Immunotherapy Phase III | Terminated (slow accrual) |
| NCT03228537 | NCI Neoadjuvant Atezolizumab + Cisplatin/Pemetrexed + Surgery (Phase I) | Neoadjuvant/Surgical Phase I — Results Posted | Active, not recruiting; results posted 2022 |
| NCT03762018 | BEAT-meso (Bev + Atezo + Chemo) | Immunotherapy Phase III | Completed; primary endpoint not met |
| NCT05278975 | MITOPE (RSO-021, intrapleural PRX3 inhibitor) | Targeted Therapy Phase 1/2 | Completed; primary completion 2025-11-30 (registry updated 2026-07-24) |
| "Pursuing a mesothelioma lawsuit does not affect your eligibility for clinical trials. In fact, the compensation our clients receive often helps cover travel costs and other expenses associated with trial participation. We believe patients deserve access to the best treatments available while also holding the companies responsible for their asbestos exposure accountable." |
| — Paul Danziger, Founding Partner, Danziger & De Llano |
External Links
- Danziger & De Llano — national mesothelioma and asbestos law firm with information on diagnosis, treatment centers offering clinical trials, and legal options for patients and families
- Mesothelioma Lawyer Center — resources on treatment options, clinical trials, and legal rights for asbestos exposure
- Mesothelioma.net — information on mesothelioma clinical trials, treatment, and prognosis
- MesotheliomaAttorney.com — attorneys experienced in asbestos litigation and trust fund claims
Related Resources
- Mesothelioma_Treatment_Options — Comprehensive overview of all treatment approaches
- Immunotherapy_for_Mesothelioma — Detailed coverage of CheckMate 743, KEYNOTE-483, and emerging immunotherapy combinations
- Bemcentinib_Plus_Pembrolizumab_for_Mesothelioma — The MIST3 phase IIa arm of the UK MiST trial: AXL plus PD-1 blockade in relapsed mesothelioma
- RSO-021_and_PRDX3_Inhibition_in_Pleural_Mesothelioma — Intrapleural PRDX3 inhibition, the MITOPE phase 1/2 trial, and mitochondrial redox as a mesothelioma target
- Stage_3_Mesothelioma — Staging, prognosis, and treatment options for locally advanced disease
- Peritoneal_Mesothelioma — Diagnosis, CRS-HIPEC, and peritoneal-specific trial options
- Survival_Statistics — Survival rates by stage, histology, and treatment modality
- Mesothelioma_Diagnosis_and_Staging — TNM staging, diagnostic workup, and biomarker testing
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 ClinicalTrials.gov — Active Mesothelioma Trials, National Library of Medicine, retrieved April 2026
- ↑ 2.0 2.1 2.2 2.3 Vogelzang NJ, Rusthoven JJ, Symanowski J, et al. Phase III study of pemetrexed in combination with cisplatin versus cisplatin alone in patients with malignant pleural mesothelioma. J Clin Oncol. 2003;21(14):2636-44. PMID 12860938.
- ↑ 3.0 3.1 3.2 3.3 Baas P, Scherpereel A, Nowak AK, et al. First-line nivolumab plus ipilimumab in unresectable malignant pleural mesothelioma (CheckMate 743): a multicentre, randomised, open-label, phase 3 trial. Lancet. 2021;397(10272):375-386. PMID 33485464.
- ↑ 4.0 4.1 4.2 4.3 4.4 4.5 Chu Q, et al. Pembrolizumab plus chemotherapy versus chemotherapy in untreated advanced pleural mesothelioma in Canada, Italy, and France: a phase 3, open-label, randomised controlled trial. The Lancet. 2023. PMID 37931632
- ↑ 5.0 5.1 5.2 5.3 5.4 5.5 FDA Approves Pembrolizumab with Chemotherapy for Malignant Pleural Mesothelioma, FDA.gov, September 2024
- ↑ 6.0 6.1 6.2 6.3 6.4 6.5 6.6 Scherpereel A et al. Five-year overall survival update from CheckMate 743: nivolumab plus ipilimumab versus chemotherapy in first-line unresectable malignant pleural mesothelioma, Journal of Clinical Oncology, February 2026
- ↑ 7.0 7.1 7.2 7.3 7.4 7.5 7.6 Yap TA et al. YAP/TEAD inhibitor VT3989 in solid tumors: a phase 1/2 trial, Nature Medicine, October 2025
- ↑ 8.0 8.1 8.2 8.3 8.4 8.5 8.6 A Phase 3, Randomized, Open-label Trial Comparing VT3989 Versus Gemcitabine or Vinorelbine in Participants With Advanced Epithelioid Mesothelioma, Who Previously Received Platinum-Based Systemic Chemotherapy and Immunotherapy (sTEADfast), ClinicalTrials.gov, sponsor Vivace Therapeutics, posted September 17, 2026.
- ↑ 9.0 9.1 Pembrolizumab in Patients With Advanced Malignant Pleural Mesothelioma (NCT02784171), ClinicalTrials.gov, posted results, Secondary Outcome: Phase III Objective Response Rate
- ↑ 10.0 10.1 10.2 10.3 10.4 Adusumilli PS et al. A phase I trial of regional mesothelin-targeted CAR T-cell therapy in patients with malignant pleural disease, in combination with anti-PD-1 agent, Cancer Discovery, 2021
- ↑ 11.0 11.1 11.2 11.3 11.4 11.5 11.6 BNT327/PM8002, a bispecific antibody targeting PD-L1 and VEGF-A, in patients with unresectable malignant pleural or peritoneal mesothelioma, ASCO 2025 Abstract 8012
- ↑ 12.0 12.1 12.2 12.3 12.4 12.5 A Study of PM8002 Injection in Combination With Standard Chemotherapy as First Line Therapy in MPM, ClinicalTrials.gov, sponsor Biotheus Inc., Phase 2, Completed (primary completion March 2026).
- ↑ 13.0 13.1 13.2 13.3 Szlosarek PW, Creelan BC, Sarkodie T, et al. Pegargiminase Plus First-Line Chemotherapy in Patients With Nonepithelioid Pleural Mesothelioma: The ATOMIC-Meso Randomized Clinical Trial. JAMA Oncol. 2024;10(4):475-483. PMID 38358753.
- ↑ 14.0 14.1 14.2 14.3 14.4 Polaris Group's Biologic License Application (BLA) for Pegargiminase (ADI-PEG 20) has officially entered the FDA substantive review stage, Polaris Group, August 18, 2025
- ↑ 15.0 15.1 15.2 Ultimovacs UV1 Telomerase Vaccine NIPU Phase II Results, Zelluna (formerly Ultimovacs) ASA, 2024
- ↑ 16.0 16.1 16.2 16.3 16.4 ISM6331 Phase I Study in Patients With Advanced Solid Tumors, ClinicalTrials.gov
- ↑ 17.0 17.1 17.2 17.3 Anti-Mesothelin TNaive/SCM hYP218 CAR T Cells in Mesothelin Expressing Cancers, ClinicalTrials.gov
- ↑ Malignant Mesothelioma Treatment, National Cancer Institute, 2026
- ↑ 19.0 19.1 19.2 19.3 19.4 19.5 MEDI5752 in Combination With Carboplatin Plus Pemetrexed in Unresectable Pleural Mesothelioma (eVOLVE-Meso), NCT06097728, ClinicalTrials.gov
- ↑ 20.0 20.1 20.2 HIT-Meso: Proton Beam Therapy in Malignant Pleural Mesothelioma, ClinicalTrials.gov
- ↑ 21.0 21.1 21.2 EVEREST-2: A2B694 in Mesothelin-Expressing Solid Tumors, ClinicalTrials.gov
- ↑ 22.0 22.1 22.2 22.3 22.4 22.5 22.6 What Are Clinical Trials?, National Cancer Institute
- ↑ 23.0 23.1 23.2 ClinicalTrials.gov — Phase 3 Mesothelioma Trials, National Library of Medicine; 28 studies returned, exactly one (NCT04996017) status RECRUITING; per-study status verified directly September 17, 2026.
- ↑ 24.0 24.1 Atezolizumab Versus Placebo for the Adjuvant Treatment of Malignant Pleural Mesothelioma (Atezomeso), ClinicalTrials.gov, sponsor Gruppo Oncologico Italiano di Ricerca Clinica.
- ↑ 25.0 25.1 VT3989 Phase I/II Study in Patients With Mesothelioma and Other Solid Tumors, ClinicalTrials.gov
- ↑ 26.0 26.1 26.2 26.3 26.4 26.5 Kindler HL, Ismaila N, Bazhenova L, Chu Q, Churpek JE, Dagogo-Jack I, et al. Treatment of Pleural Mesothelioma: ASCO Guideline Update. J Clin Oncol. 2025;43(8):1006-1038. PMID 39778125. PubMed
- ↑ Global Landscape of Mesothelin-Targeted CAR-T Cell Therapy in Solid Tumors, Frontiers in Immunology, 2025
- ↑ Mesothelin-Targeted CAR T Cells With PD1DNR in Malignant Pleural Disease, ClinicalTrials.gov
- ↑ 29.0 29.1 TNhYP218 CAR-T Trial, NCI Cancer.gov
- ↑ 30.0 30.1 STAR-101: SynKIR-110 in Mesothelin-Expressing Advanced Solid Tumors, ClinicalTrials.gov
- ↑ Verismo Therapeutics Secures FDA Fast Track Designation for SynKIR-110, PR Newswire, April 5, 2023; Verismo Therapeutics Receives FDA Orphan Drug Designation for SynKIR-110, PR Newswire, September 28, 2022
- ↑ CD70-Targeted CAR-T Cells in Advanced Solid Tumors, ClinicalTrials.gov
- ↑ TEADES: A Phase 1/2 First-in-Human Study of ODM-212 in Selected Advanced Solid Tumours (NCT06725758), ClinicalTrials.gov
- ↑ A Phase 1/2 Trial of ODM-212 in Combination With Anti-cancer Therapy in Advanced Solid Tumours (NCT07563738), ClinicalTrials.gov
- ↑ 35.0 35.1 Phase II Study of Tazemetostat in Malignant Mesothelioma, ClinicalTrials.gov
- ↑ Tulmimetostat in Advanced Malignancies Including Mesothelioma, ClinicalTrials.gov
- ↑ MRTX1719 in Patients With MTAP-Deleted Advanced Solid Tumors, ClinicalTrials.gov
- ↑ Olaparib in HRD Mesothelioma, ClinicalTrials.gov
- ↑ 39.0 39.1 Sacituzumab Govitecan in Previously Treated Malignant Pleural Mesothelioma, ClinicalTrials.gov
- ↑ NIPU: UV1 Vaccination With Nivolumab and Ipilimumab in Mesothelioma, ClinicalTrials.gov
- ↑ 41.0 41.1 41.2 41.3 41.4 Ceresoli GL, Aerts JG, Dziadziuszko R, et al. Tumour Treating Fields in combination with pemetrexed and cisplatin or carboplatin as first-line treatment for unresectable malignant pleural mesothelioma (STELLAR): a multicentre, single-arm phase 2 trial. Lancet Oncol. 2019;20(12):1702-1709. PMID 31628016.
- ↑ 42.0 42.1 42.2 Yan TD et al. Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Malignant Peritoneal Mesothelioma: Multi-Institutional Experience, Journal of Clinical Oncology, 2009
- ↑ 43.0 43.1 ICARuS II: Intraperitoneal Chemotherapy for Peritoneal Mesothelioma, ClinicalTrials.gov
- ↑ PIPAC with Nab-Paclitaxel for Peritoneal Malignancies, ClinicalTrials.gov
- ↑ Smolenschi C, Boileve A, Vaflard P, et al. Real-world immunotherapy outcomes in unresectable peritoneal mesothelioma: A French experience. Eur J Cancer. 2025;231:116066. PMID 41207181.
- ↑ 46.0 46.1 46.2 46.3 46.4 46.5 46.6 46.7 Clinical Trial Eligibility Guide, National Cancer Institute
- ↑ 47.0 47.1 Reuss JE, Lee PK, Mehran RJ, et al. Perioperative nivolumab or nivolumab plus ipilimumab in resectable diffuse pleural mesothelioma: a phase 2 trial and ctDNA analyses. Nat Med. 2025;31(12):4097-4108. PMID 40921804.
- ↑ Lalloo F, Kulkarni A, Chau C, Nielsen M, Sheaff M, Steele J, et al. Clinical practice guidelines for the diagnosis and surveillance of BAP1 tumour predisposition syndrome. Eur J Hum Genet. 2023;31(11):1261-1269. PMID 37607989. PMC10620132. PubMed
- ↑ 49.0 49.1 49.2 ClinicalTrials.gov — U.S. National Library of Medicine, NIH/NLM
- ↑ 50.0 50.1 50.2 Paying for Clinical Trials, National Cancer Institute
- ↑ Affordable Care Act Implementation FAQ — Clinical Trials, Centers for Medicare & Medicaid Services
- ↑ Clinical Research Studies Coverage, Medicare.gov
- ↑ UPDATED: Mandatory Medicaid Coverage of Routine Patient Costs Furnished in Connection with Participation in Qualifying Clinical Trials (SMD #21-005), Centers for Medicare & Medicaid Services
- ↑ 54.0 54.1 VA Clinical Trials for Veterans, U.S. Department of Veterans Affairs
- ↑ 55.0 55.1 NCT03228537: A Feasibility Trial of Neoadjuvant Cisplatin-Pemetrexed With Atezolizumab in Combination and in Maintenance for Resectable Malignant Pleural Mesothelioma, National Cancer Institute, ClinicalTrials.gov. Accessed 2026-06-15.
- ↑ MVdeltaC Receives FDA Orphan Drug Designation in Pleural Mesothelioma, OncLive, June 2025
- ↑ DREAM3R: Durvalumab With Chemotherapy in Mesothelioma, ClinicalTrials.gov
- ↑ Nowak A. Primary results of DREAM3R: DuRvalumab (MEDI4736) with chemotherapy as first line treatment in advanced pleural Mesothelioma – A phase 3 Randomised trial. Presented at: 2025 ESMO Congress; October 17-20, 2025; Berlin, Germany. Abstract LBA104. Summary: OncLive, October 19, 2025
- ↑ Felip E, et al. A randomised phase III study of bevacizumab and carboplatin-pemetrexed chemotherapy with or without atezolizumab as first-line treatment for advanced pleural mesothelioma: results of the ETOP 13-18 BEAT-meso trial. Ann Oncol. 2025. PMID 39814199
- ↑ Gibson V, Dzialo J, Messier T, et al. Preclinical characterization and phase 1 clinical testing of targeting mitochondrial peroxiredoxin 3 in cancer. Nat Commun. 2026;17(1):5929. PMID 42448681.
- ↑ ClinicalTrials.gov. A Translational Phase 1/2 Dose-Escalation and Expansion Study to Determine Safety, Tolerability, and Recommended Phase 2 Dose of RSO-021 in Patients With Malignant Pleural Effusion Due to Advanced/Metastatic Solid Tumors Including Mesothelioma (NCT05278975). Sponsor: RS Oncology LLC. Status: Completed. Registry record last updated 2026-07-24.
- ↑ Scherpereel A, Baas P, Nowak AK, et al. Five-Year Clinical Outcomes With Nivolumab Plus Ipilimumab Versus Chemotherapy as First-Line Treatment for Unresectable Pleural Mesothelioma in CheckMate 743. Journal of Clinical Oncology 2026. PMID 41734361. Free full text: PMC13001902.
- ↑ Keytruda QLEX (pembrolizumab and berahyaluronidase alfa-pmph) — Full Prescribing Information, DailyMed/NLM