Condition

Mesothelioma

Clinical trials and treatment information for Mesothelioma

52K

People Affected

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.

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)

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Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

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

Monitoring

$25,000

Side Effects

$25,000

Total Annual

$150,000

Cost-Effectiveness

POOR

QALYs Gained

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%

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

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Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

2-4 months

Duration

Up to 2 years for Nivolumab, Ipilimumab 4 doses

Response Rate

40%

Remission Rate

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

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

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Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

2-4 months

Duration

Up to 2 years for Durvalumab, Tremelimumab 4 doses

Response Rate

35%

Remission Rate

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

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

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Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

6-9 weeks (initial response)

Duration

6 cycles + maintenance Bevacizumab

Response Rate

55%

Remission Rate

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

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

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Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

6-9 weeks (initial response)

Duration

4-6 cycles (3-6 months)

Response Rate

45%

Remission Rate

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