What New Treatments Are Being Tested for Mesothelioma?

Immunotherapy Advances

Building on the FDA approval of nivolumab plus ipilimumab in 2020, researchers are testing new immunotherapy approaches for mesothelioma. These include combinations of checkpoint inhibitors with chemotherapy, novel checkpoint targets beyond PD-1 and CTLA-4, and immune-stimulating agents such as oncolytic viruses that infect and destroy cancer cells while activating the immune system.

Anti-mesothelin antibody-drug conjugates (ADCs) represent another promising immunotherapy approach. These engineered molecules combine an antibody that targets the mesothelin protein — highly expressed on mesothelioma cells — with a potent chemotherapy payload. The antibody delivers the drug directly to cancer cells, potentially increasing effectiveness while reducing side effects.

CAR T-Cell Therapy

CAR T-cell therapy involves collecting a patient's own immune cells, genetically engineering them to recognize and attack cancer cells, and infusing them back into the patient. Several clinical trials are testing CAR T-cells that target mesothelin in mesothelioma patients. Early results from institutions including Memorial Sloan Kettering Cancer Center have shown promising responses in some patients.

Researchers are also developing next-generation CAR T-cell approaches that incorporate additional engineering to help the cells persist longer in the body, overcome the immunosuppressive tumor microenvironment, and reduce side effects such as cytokine release syndrome.

Targeted Therapies and Gene Therapy

Genomic research has identified specific mutations common in mesothelioma tumors, including loss of the BAP1, NF2, and CDKN2A genes. Clinical trials are testing drugs that target the downstream effects of these mutations. For example, EZH2 inhibitors target a pathway activated by BAP1 loss, and CDK4/6 inhibitors address CDKN2A deletion. These targeted approaches aim to exploit vulnerabilities specific to each patient's tumor.

Gene therapy approaches are also under investigation, including strategies to restore tumor suppressor gene function or deliver therapeutic genes directly into tumor cells using viral vectors. While still in early phases, these approaches represent a fundamentally different treatment strategy for mesothelioma.

Other Emerging Approaches

Tumor Treating Fields (TTFields) — a wearable device that generates alternating electric fields to disrupt cancer cell division — is being studied in combination with chemotherapy for mesothelioma. The STELLAR trial showed improved survival when TTFields were added to standard chemotherapy, and this approach received FDA approval for mesothelioma treatment.

Discuss emerging treatments with your oncologist to determine whether any current trials are appropriate for your situation. Pursuing legal compensation for asbestos exposure can help cover costs associated with accessing these innovative treatments.