Mesothelioma Clinical Trials 2026: New Immunotherapy and Targeted Treatments

Mesothelioma clinical trials are producing breakthrough results in 2026, with immunotherapy combinations quadrupling survival rates and CAR T-cell therapies showing unprecedented promise [1]. More than 56 active trials are testing new treatments at cancer centers across the country, yet only 8% of mesothelioma patients participate in clinical research [4]. For many patients, clinical trials offer access to cutting-edge treatments that could significantly extend survival.

Executive Summary

Mesothelioma treatment is entering a new era of precision medicine and immunotherapy, with clinical trials producing some of the most encouraging results in decades. The ATOMIC-Meso trial demonstrated that ADI-PEG20 combined with chemotherapy quadrupled 3-year survival rates [1]. The NCI has invested $10.7 million in CAR T-cell research targeting mesothelin, a protein found on 90% of mesothelioma cells [2]. Johns Hopkins trials show perioperative immunotherapy achieves 80% surgical success rates with 28.6-month median survival [3]. Despite these advances, participation remains low—understanding trial options and eligibility requirements can help patients access potentially life-extending treatments.

8 Key Facts About Mesothelioma Clinical Trials in 2026

Active Trials: 56+ registered on ClinicalTrials.gov [4]
Patient Participation Rate: Only 8% of patients enroll [4]
ATOMIC-Meso Results: 4x improvement in 3-year survival [1]
NCI CAR T Investment: $10.7 million for mesothelin-targeted therapy [2]
Perioperative Immunotherapy: 80% surgical success, 28.6-month median survival [3]
Trial Phases: Phase 1 (safety), Phase 2 (efficacy), Phase 3 (comparison)
Major Trial Centers: MD Anderson, Memorial Sloan Kettering, Penn Abramson
Cost: Experimental treatment typically covered; standard care may require insurance

What Are the Most Promising Mesothelioma Clinical Trials in 2026?

Several clinical trials are producing results that may change how mesothelioma is treated. Understanding these advances helps patients make informed decisions about participating in research.

ATOMIC-Meso Trial: Quadrupling Survival Rates

The ATOMIC-Meso Phase 3 trial tested ADI-PEG20 (pegargiminase), a drug that starves cancer cells of arginine—an amino acid many mesotheliomas depend on [1]. Results showed patients receiving ADI-PEG20 plus chemotherapy had:

Improvement in 3-year survival with ADI-PEG20 plus chemotherapy

Quadrupled 3-year survival rates compared to chemotherapy alone
Improved progression-free survival
Manageable side effect profile

This arginine deprivation therapy represents a new approach to mesothelioma treatment and is moving toward FDA approval consideration based on these results.

"The ATOMIC-Meso results are genuinely exciting—we don't often see a quadrupling of survival rates in mesothelioma trials. In my 18 years advocating for patients, these are some of the most encouraging numbers I've seen. Patients should ask their oncologists about arginine deprivation therapy options."
— David Foster, Executive Director of Client Services, Danziger & De Llano

CAR T-Cell Therapy: NCI's $10.7 Million Initiative

The National Cancer Institute awarded $10.7 million to Penn's Abramson Cancer Center for CAR T-cell therapy research targeting mesothelioma [2]. This approach engineers a patient's own immune cells to attack cancer cells expressing mesothelin—a protein found on approximately 90% of mesothelioma tumors.

Current CAR T trials at Penn and NCI include:

TNhYP218 Trial: Testing enhanced CAR T cells with improved persistence
Combination Approaches: CAR T with checkpoint inhibitors
Regional Delivery: Direct delivery into the pleural space

The clinical trials overview provides additional information on CAR T-cell research.

Perioperative Immunotherapy: Johns Hopkins Results

Johns Hopkins Sidney Kimmel Cancer Center reported impressive results combining immunotherapy with surgery [3]. Their perioperative approach—giving immunotherapy before and after surgery—achieved:

80% of patients successfully completed surgery
28.6-month median survival
Improved complete pathologic response rates

This trial suggests that timing immunotherapy around surgery may enhance its effectiveness for patients who are surgical candidates.

YAP-TEAD Pathway Inhibitors: ESMO 2025 Results

A new class of targeted drugs presented at the European Society for Medical Oncology (ESMO) 2025 congress showed promise for mesothelioma [5]. YAP-TEAD pathway inhibitors target a molecular pathway commonly activated in mesothelioma cells, particularly those with NF2 gene mutations.

Early-phase trial results showed:

Encouraging response rates in heavily pre-treated patients
Disease stabilization in a majority of participants
Manageable toxicity profile

What Types of Mesothelioma Clinical Trials Are Available?

Clinical trials test different treatment approaches. Understanding the categories helps patients identify relevant research opportunities.

Immunotherapy Trials

Immunotherapy uses the body's immune system to fight cancer. Current mesothelioma immunotherapy trials include:

Approach	Examples	How It Works
Checkpoint Inhibitors	Keytruda, Opdivo, Yervoy combinations	Releases immune system "brakes" on cancer attack
CAR T-Cell Therapy	Mesothelin-targeted CAR T	Engineers patient's T cells to attack cancer
Cancer Vaccines	WT1 peptide vaccines	Trains immune system to recognize tumor cells
Oncolytic Viruses	Modified measles virus	Uses viruses to infect and destroy cancer cells

Targeted Therapy Trials

Targeted therapies attack specific molecular features of cancer cells:

ADI-PEG20: Targets arginine dependence in mesothelioma cells
YAP-TEAD Inhibitors: Targets Hippo pathway dysfunction
Anti-angiogenesis Drugs: Cuts off tumor blood supply
PARP Inhibitors: Exploits DNA repair deficiencies

Combination Therapy Trials

Many current trials test combinations of existing treatments:

Immunotherapy plus chemotherapy
Surgery plus perioperative immunotherapy
Dual checkpoint inhibitor combinations
Chemotherapy plus targeted therapy

Surgical and Procedural Trials

Trials testing new surgical approaches or delivery methods:

Photodynamic therapy after surgery
Intrapleural chemotherapy delivery
HIPEC (heated intraperitoneal chemotherapy) for peritoneal mesothelioma
Tumor-treating fields (TTFields)

How Do You Find Mesothelioma Clinical Trials?

Finding appropriate clinical trials requires knowing where to look and understanding eligibility criteria.

ClinicalTrials.gov

The U.S. National Library of Medicine maintains ClinicalTrials.gov, a database of all registered clinical trials [4]. To search for mesothelioma trials:

Go to ClinicalTrials.gov
Enter "mesothelioma" in the condition field
Filter by location, recruitment status, and phase
Review eligibility criteria for each trial

Major Cancer Centers

The leading mesothelioma treatment centers run multiple clinical trials:

MD Anderson Cancer Center: Multiple immunotherapy and surgical trials
Memorial Sloan Kettering: CAR T-cell and combination therapy trials
Penn Abramson Cancer Center: NCI-funded CAR T research
Brigham and Women's Hospital: Surgical innovation trials
Moffitt Cancer Center: Immunotherapy combination trials

Your Oncologist

Your treating oncologist can help identify trials that match:

Your specific mesothelioma type (pleural vs. peritoneal)
Your treatment history
Your overall health status
Your geographic location

"I always encourage patients to ask about clinical trials at their very first appointment—not as a last resort. Trials often have eligibility windows, and starting the conversation early gives patients more options. The breakthrough treatments of tomorrow are being tested today."
— David Foster, Executive Director of Client Services, Danziger & De Llano

What Are the Eligibility Requirements for Clinical Trials?

Every clinical trial has specific eligibility criteria designed to ensure patient safety and generate meaningful scientific data.

Common Inclusion Criteria

Confirmed diagnosis: Pathologically confirmed mesothelioma
Mesothelioma type: Some trials accept all types; others specify pleural or peritoneal
Performance status: Measure of overall function (ECOG score 0-2 typically required)
Organ function: Adequate kidney, liver, and bone marrow function
Treatment history: Some trials require no prior treatment; others require specific prior therapies

Common Exclusion Criteria

Active brain metastases (in most trials)
Uncontrolled medical conditions
Recent major surgery (varies by trial)
Autoimmune diseases (for immunotherapy trials)
Pregnancy or breastfeeding

Treatment-Naive vs. Previously Treated

Some trials specifically seek:

Treatment-naive patients: No prior chemotherapy, radiation, or surgery
Second-line patients: Cancer progressed after one line of treatment
Heavily pre-treated patients: Failed multiple prior therapies

What Should You Expect When Joining a Clinical Trial?

Understanding the clinical trial process helps patients prepare for participation.

Screening Process

Before enrollment, you'll undergo screening to confirm eligibility:

Medical history review
Physical examination
Laboratory tests (blood work, organ function)
Imaging studies (CT, PET scans)
Pathology review

Informed Consent

The informed consent process ensures you understand:

What treatment you'll receive
Potential risks and benefits
Alternative treatment options
Your right to withdraw at any time
How your data will be used

Treatment Schedule

Clinical trials typically require:

Regular treatment visits (weekly, biweekly, or monthly)
Frequent monitoring (blood tests, scans)
Documentation of side effects
Follow-up visits after treatment ends

Costs and Coverage

Clinical trial costs typically break down as:

Usually Covered by Trial	Usually Billed to Insurance
Experimental drug/treatment	Standard medical care
Research-specific tests	Routine laboratory tests
Some travel expenses	Hospital stays for standard care
Study coordinator support	Office visits for routine monitoring

Why Do Only 8% of Mesothelioma Patients Join Clinical Trials?

Despite the potential benefits, clinical trial participation remains low. Understanding barriers helps address them [4].

Common Barriers to Participation

Lack of awareness: Many patients don't know trials exist
Geography: Trials may be far from home
Eligibility concerns: Patients assume they won't qualify
Fear of randomization: Concern about receiving placebo
Time commitment: Frequent visits can be burdensome
Physician hesitation: Some doctors don't discuss trial options

Overcoming Barriers

Ask early: Discuss trials at your first appointment
Consider travel: Many trials offer travel assistance
Review multiple trials: Different eligibility criteria may apply
Understand design: Not all trials use placebos
Seek second opinions: Major cancer centers may have more options

"In 20 years in the pharmaceutical industry and 18 years in mesothelioma advocacy, I've seen too many patients miss out on trials simply because they didn't know to ask. I tell everyone: clinical trials aren't a last resort—they're often where the best medicine is being practiced."
— David Foster, Executive Director of Client Services, Danziger & De Llano

What Questions Should You Ask About Clinical Trials?

When considering a clinical trial, ask your medical team:

About the Trial

What is the purpose of this trial?
What phase is the trial in?
What treatment will I receive?
Is there a placebo arm?
What are the expected benefits and risks?

About Participation

How often will I need to visit the treatment center?
What tests and procedures are required?
How long will the trial last?
What happens if my cancer progresses during the trial?
Can I continue the treatment after the trial ends if it works?

About Costs and Logistics

What costs are covered by the trial?
What costs will be billed to my insurance?
Is travel assistance available?
Who do I contact if I have problems or questions?

Frequently Asked Questions

How many mesothelioma clinical trials are currently active?

As of 2026, there are 56+ active mesothelioma clinical trials registered on ClinicalTrials.gov. These trials are testing immunotherapy combinations, CAR T-cell therapy, targeted treatments, and novel drug delivery methods. However, only about 8% of mesothelioma patients participate in clinical trials.

What is the most promising mesothelioma treatment in clinical trials?

The ATOMIC-Meso trial results showed ADI-PEG20 (pegargiminase) quadrupled 3-year survival rates when combined with chemotherapy. CAR T-cell therapies targeting mesothelin are also showing strong results, with the NCI investing $10.7 million in this research at Penn's Abramson Cancer Center.

Can I join a mesothelioma clinical trial after starting treatment?

It depends on the specific trial. Some trials enroll treatment-naive patients only, while others accept patients who have already received chemotherapy or surgery. Each trial has specific eligibility criteria. Your oncologist can help identify trials that match your treatment history.

Are mesothelioma clinical trials free?

Clinical trials typically cover the cost of the experimental treatment and related monitoring. However, standard care costs (hospital stays, routine tests) may still be billed to insurance. Many trials also provide travel assistance for patients who must travel to treatment centers.

What are the risks of joining a mesothelioma clinical trial?

Clinical trial risks include unknown side effects from experimental treatments, the possibility of receiving a placebo (in some trials), and additional time commitments for monitoring. However, trials provide close medical supervision and access to cutting-edge treatments not otherwise available.

How do I find mesothelioma clinical trials near me?

ClinicalTrials.gov lists all registered mesothelioma trials with location information. Major cancer centers like MD Anderson, Memorial Sloan Kettering, and Penn's Abramson Cancer Center run multiple trials. Your oncologist can also identify trials matching your diagnosis and eligibility.

Next Steps: Exploring Clinical Trial Options

Clinical trials offer mesothelioma patients access to potentially life-extending treatments not available through standard care. With trials showing quadrupled survival rates and new approaches targeting cancer at the molecular level, 2026 is an encouraging time for mesothelioma research.

Our patient advocacy team can help connect you with mesothelioma specialists who participate in clinical trials and assist with the practical aspects of trial participation. We believe every patient deserves to know their options.

Related Resources

Top 6 Mesothelioma Treatment Centers 2026 — Leading cancer centers
Find Mesothelioma Specialists — Connect with experts nationwide
Free Case Assessment — Get personalized guidance

Learn More About Treatment

Clinical Trials Overview — Detailed trial information
Treatment Options — Complete treatment guide
Treatment Centers — Specialized facility information

Sources:

Journal of Clinical Oncology. (2025). ATOMIC-Meso Trial: Phase 3 Results.
National Cancer Institute. (2025). CAR T-Cell Therapy for Mesothelioma: NCI Research Initiative.
Johns Hopkins Sidney Kimmel Cancer Center. (2025). Perioperative Immunotherapy Trial Results.
U.S. National Library of Medicine. (2026). ClinicalTrials.gov Mesothelioma Search.
European Society for Medical Oncology. (2025). YAP-TEAD Pathway Inhibitors: ESMO 2025 Presentation.

Last updated: January 28, 2026