Condition

Mesothelioma

Clinical trials and treatment information for Mesothelioma

52K
People Affected
50
Active Trials
26K
New Cases/Year
30K
Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

1
Surgery (Pleurectomy/Decortication or Extrapleural Pneumonectomy) + Adjuvant Therapy
85% Effectiveness• 75% Confidence• 25% Safety• 1 trials• 15K participants
MODERATE EvidencePoor ValueDose: N/A (surgical procedure)
Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
25
DangerousModerateSafe

Time to Effect

Immediate tumor removal, long recovery (weeks-months)

Duration

Single procedure, followed by long recovery and adjuvant therapy for months-years

Response Rate

%

Remission Rate

15%

Common Side Effects:

Post-operative pain: 70%
Respiratory complications (e.g., pneumonia): 30%
Cardiac complications (e.g., arrhythmia): 15%
Empyema/Infection: 10%
Hemorrhage: 7%
Mortality (EPP): 8%
Mortality (P/D): 3%

Annual Cost of Care

Drug Cost

$0

Monitoring

$25,000

Side Effects

$25,000

Total Annual

$150,000

Cost-Effectiveness

POOR

QALYs Gained

1

ICER

$200,000/QALY

Cost per Remission

$1,000,000

Treatment Outcomes
Primary Outcomes
Overall SurvivalMedian expected survival 12 months (without aggressive multimodal therapy)
+67% (+8 months (from 12 to 20 months median OS))
Progression-Free SurvivalMedian PFS 5 months (without aggressive multimodal therapy)
+80% (+4 months (from 5 to 9 months median PFS))
Local Recurrence Rate at 1 yearExpected 50% (after surgery alone without adjuvant therapy)
-50% (-25 percentage points (from 50% to 25%))
Dyspnea Severity (Modified Borg Scale)Modified Borg Scale score: 5/10 (moderate-severe shortness of breath)
-60% (-3 points on Modified Borg Scale)
Secondary Benefits
Quality of Life (EORTC QLQ-C30 Global Health Score)EORTC QLQ-C30 Global Health Score: 50/100 (moderate impairment, higher is better)
+30% (+15 points on EORTC QLQ-C30 Global Health Score)
Chest Pain Severity (Numeric Rating Scale)NRS: 6/10 (moderate pain)
-50% (-3 points on Numeric Rating Scale)
Fatigue Severity (FACT-F Scale)FACT-F score: 30/52 (moderate fatigue, higher score is less fatigue)
+27% (+8 points on FACT-F Scale)
Common Side Effects
Post-operative pain
+70%
Respiratory complications (e.g., pneumonia)
+30%
Cardiac complications (e.g., arrhythmia)
+15%
2
Nivolumab + Ipilimumab
75% Effectiveness• 90% Confidence• 35% Safety• 18 trials• 8K participants
HIGH EvidenceModerate ValueDose: Nivolumab 360mg Q3W + Ipilimumab 1mg/kg Q6W x4, then Nivolumab monotherapy
Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
35
DangerousModerateSafe

Time to Effect

2-4 months

Duration

Up to 2 years for Nivolumab, Ipilimumab 4 doses

Response Rate

40%

Remission Rate

5%

Common Side Effects:

Fatigue: 40%
Diarrhea: 30%
Rash: 25%
Nausea: 20%
Hypothyroidism: 12%
Pneumonitis: 7%
Colitis: 6%

Annual Cost of Care

Drug Cost

$244,000

Monitoring

$12,000

Side Effects

$15,000

Total Annual

$271,000

Cost-Effectiveness

MODERATE

QALYs Gained

0.3

ICER

$120,000/QALY

Cost per Remission

$5,420,000

Cost per Responder

$677,500

Treatment Outcomes
Primary Outcomes
Overall Survival (OS)Median OS with chemotherapy: 14.1 months
+28.4% (+4.0 months)
Overall Response Rate (ORR)ORR with chemotherapy: 23%
+73.9% (+17 percentage points)
Disease Control Rate (DCR)DCR with chemotherapy: 68%
+23.5% (+16 percentage points)
Duration of Response (DoR)Median DoR with chemotherapy: 6.7 months
+64.2% (+4.3 months)
Secondary Benefits
Health-Related Quality of Life (HRQoL)EORTC QLQ-C30 Global Health Status/QoL scale: 60/100 points
+8% (+4.8 points)
Fatigue SeverityFACIT-F (Functional Assessment of Chronic Illness Therapy - Fatigue) score: 28/52 points
+10% (+2.8 points)
Pain IntensityBrief Pain Inventory (BPI) worst pain score: 7/10 points
-20% (-1.4 points)
Common Side Effects
Fatigue
+40%
Diarrhea
+30%
Rash
+25%

Clinical Trial Phases:

Phase 3Phase 4
3
Durvalumab + Tremelimumab
72% Effectiveness• 85% Confidence• 35% Safety• 6 trials• 5K participants
HIGH EvidenceModerate ValueDose: Tremelimumab 1mg/kg D1 (x4) + Durvalumab 1500mg Q3W (x4), then Durvalumab 1500mg Q4W
Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
35
DangerousModerateSafe

Time to Effect

2-4 months

Duration

Up to 2 years for Durvalumab, Tremelimumab 4 doses

Response Rate

35%

Remission Rate

5%

Common Side Effects:

Diarrhea: 30%
Fatigue: 35%
Nausea: 20%
Rash: 20%
Hepatitis: 7%
Colitis: 6%

Annual Cost of Care

Drug Cost

$260,000

Monitoring

$12,000

Side Effects

$15,000

Total Annual

$287,000

Cost-Effectiveness

MODERATE

QALYs Gained

0.3

ICER

$130,000/QALY

Cost per Remission

$5,740,000

Cost per Responder

$820,000

Treatment Outcomes
Primary Outcomes
Overall SurvivalMedian OS with standard chemotherapy: 14.1 months
+28.37% (+4.0 months)
Objective Response RateORR with standard chemotherapy: 32%
+25% (+8 percentage points)
1-Year Overall Survival Rate1-year OS rate with standard chemotherapy: 55%
+23.64% (+13 percentage points)
Secondary Benefits
Duration of ResponseMedian DoR with standard chemotherapy: 6 months
+100% (+6 months)
Global Health Status/QoL (EORTC QLQ-C30)Baseline QoL score: 65 points
+10.77% (+7 points)
Dyspnea Severity (Numeric Rating Scale)Baseline average dyspnea score: 6/10
-33.33% (-2 points)
Common Side Effects
Diarrhea
+30%
Fatigue
+35%
Nausea
+20%

Clinical Trial Phases:

Phase 3
4
Bevacizumab + Pemetrexed + Cisplatin
65% Effectiveness• 85% Confidence• 20% Safety• 3 trials• 3K participants
HIGH EvidencePoor ValueDose: Bevacizumab 15mg/kg Q3W + Pemetrexed 500mg/m² Q3W + Cisplatin 75mg/m² Q3W
Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
20
DangerousModerateSafe

Time to Effect

6-9 weeks (initial response)

Duration

6 cycles + maintenance Bevacizumab

Response Rate

55%

Remission Rate

5%

Common Side Effects:

Neutropenia: 35%
Fatigue: 45%
Nausea/Vomiting: 30%
Hypertension: 25%
Proteinuria: 15%
Hemorrhage: 12%
GI perforation: 3%

Annual Cost of Care

Drug Cost

$80,000

Monitoring

$15,000

Side Effects

$12,000

Total Annual

$107,000

Cost-Effectiveness

POOR

QALYs Gained

0.3

ICER

$175,000/QALY

Cost per Remission

$2,140,000

Cost per Responder

$194,545

Treatment Outcomes
Primary Outcomes
Overall SurvivalMedian 16.1 months (Pemetrexed + Cisplatin alone)
+16.77% (+2.7 months)
Progression-Free SurvivalMedian 6.9 months (Pemetrexed + Cisplatin alone)
+33.33% (+2.3 months)
Overall Response Rate (CR+PR)30.4% (Pemetrexed + Cisplatin alone)
+29.93% (+9.1 percentage points)
Disease Control Rate (CR+PR+SD)79.1% (Pemetrexed + Cisplatin alone)
+10.11% (+8.0 percentage points)
Secondary Benefits
Global Health Status (EORTC QLQ-C30)50 points (Scale 0-100, higher is better)
+10% (+5 points)
Pain Intensity Score (EORTC QLQ-LC13)40 points (Scale 0-100, higher is worse)
-20% (-8 points)
Dyspnea Intensity Score (EORTC QLQ-LC13)45 points (Scale 0-100, higher is worse)
-15.56% (-7 points)
Common Side Effects
Neutropenia
+35%
Fatigue
+45%
Nausea/Vomiting
+30%

Clinical Trial Phases:

Phase 3
5
Pemetrexed + Cisplatin (or Carboplatin)
60% Effectiveness• 95% Confidence• 25% Safety• 21 trials• 12K participants
HIGH EvidenceModerate ValueDose: Pemetrexed 500mg/m² IV D1 + Cisplatin 75mg/m² IV D1, every 21 days
Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
25
DangerousModerateSafe

Time to Effect

6-9 weeks (initial response)

Duration

4-6 cycles (3-6 months)

Response Rate

45%

Remission Rate

5%

Common Side Effects:

Neutropenia: 25%
Fatigue: 40%
Nausea/Vomiting: 30%
Anorexia: 20%
Anemia: 25%
Nephrotoxicity (Cisplatin): 15%

Annual Cost of Care

Drug Cost

$5,000

Monitoring

$8,000

Side Effects

$7,000

Total Annual

$20,000

Cost-Effectiveness

MODERATE

QALYs Gained

0.2

ICER

$110,000/QALY

Cost per Remission

$400,000

Cost per Responder

$44,444

Treatment Outcomes
Primary Outcomes
Overall Survival9.3 months (median for cisplatin alone)
+30.1% (+2.8 months)
Progression-Free Survival3.9 months (median for cisplatin alone)
+46.2% (+1.8 months)
Overall Response Rate (CR+PR)0% (expected with best supportive care)
+41.3% (+41.3%)
Disease Control Rate (CR+PR+SD)0% (expected with best supportive care)
+81.1% (+81.1%)
Secondary Benefits
Pain Severity (LCSS)4.5/10 (moderate)
-20% (-0.9 points on 10-point scale)
Dyspnea Severity (LCSS)5.0/10 (moderate)
-18% (-0.9 points on 10-point scale)
Fatigue Severity (LCSS)5.5/10 (moderate to severe)
-14.5% (-0.8 points on 10-point scale)
Common Side Effects
Neutropenia
+25%
Fatigue
+40%
Nausea/Vomiting
+30%

Clinical Trial Phases:

Phase 3Phase 4