New mesothelioma treatments include immunotherapy combinations, gene therapy and enzyme therapy. Early clinical trials show extended survival and slowed tumor growth with these approaches. Patients today have more options than ever to improve quality of life and live longer.
Written by Karen Selby, RN | Edited by Amy Edel | Last Update: March 2, 2026
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New mesothelioma treatments are giving patients more options in addition to traditional surgery, chemotherapy and radiation. Immunotherapy drugs like Opdivo, Yervoy and Keytruda began in clinical trials and are now approved as first-line treatments, showing how emerging therapies can become standard care. Newer immunotherapy combinations and emerging therapies like gene therapy, enzyme therapy and cancer vaccines continue to produce encouraging results in clinical trials.
Key Facts About New Mesothelioma Treatments
For example, ADI-PEG20 (pegargiminase) is an enzyme therapy doctors have studied for about 20 years. But in a 2024 clinical trial, patients who took ADI-PEG20 with chemotherapy lived 4 times longer after 3 years than those who got only standard chemo. This was a major step forward for people living with mesothelioma.
Immunotherapy drugs Opdivo, Yervoy and Keytruda are all now approved as first-line treatments for pleural mesothelioma. Once considered emerging treatments, immunotherapy continues to evolve as researchers test new drugs and combinations with other therapies.
Targeted therapy is showing strong promise for mesothelioma. It targets only cancer cells, not healthy cells. Targeted therapies focus on the genes or proteins in mesothelioma cells. This helps make treatment more personal and, in some cases, more effective.
| Immunotherapy | Checkpoint Inhibitors | Targeted Therapy | |
|---|---|---|---|
| How it works | Activates the immune system to find and attack cancer cells | Classified as immunotherapy but can also be considered targeted therapy because they target specific proteins cancer cells use to evade the immune system | Blocks specific genes, proteins or enzymes in mesothelioma cells |
| Examples | Cytokines | Opdivo and Yervoy (approved together); Keytruda | Olaparib, Tazverik |
| FDA status | In active clinical trials | Opdivo and Yervoy approved first-line 2020; Keytruda approved first-line 2024 | Multiple drugs in active clinical trials |
Enzyme therapy for mesothelioma disrupts the chemical processes cancer cells depend on to grow and spread. ADI-PEG20 enzyme therapy did well in the ATOMIC-Meso clinical trial. Now, researchers are testing other enzyme therapies. One trial is testing the targeted therapy olaparib.
Olaparib is considered a type of enzyme therapy called enzyme inhibition therapy. It blocks PARP enzymes, which cancer cells use to repair their DNA. When these enzymes are blocked, the cancer cells can’t fix themselves and eventually die.
Epigenetic therapy is a type of targeted therapy. It changes how genes turn on or off without changing the DNA itself. This can slow cancer growth. One clinical trial is studying Tazverik (tazemetostat) for mesothelioma. This drug is already used to treat some soft tissue cancers, like those in muscles and nerves.
As Sean Marchese, RN, explains, “Some of the most exciting treatments for mesothelioma involve changing DNA or genes. Genomic sequencing is going to be the future of personalized medicine.”
Gene therapy for mesothelioma delivers new or modified genes directly into cells to stop cancer from growing or help the immune system fight it. Two approaches currently being tested in clinical trials show particular promise.
Suicide gene therapy introduces a gene into cancer cells that makes them sensitive to a drug that would otherwise cause little harm. When the drug is administered, it triggers cell death in the cancer cells, making chemotherapy far more effective while sparing healthy tissue.
A second approach targets BAP1, a tumor suppressor gene that is commonly mutated or lost in mesothelioma patients. When BAP1 stops functioning, cells lose an important brake on uncontrolled growth. Restoring a working copy of BAP1 through gene therapy may help slow or stop tumor development.
Mesothelin is a protein that appears in high levels on mesothelioma cells but not on most healthy cells. This makes it useful for treatments designed to seek out and attack mesothelioma while leaving healthy tissue alone. Mesothelin-targeted therapies can work as immunotherapy, targeted therapy or a combination of both, and several are currently being studied in clinical trials for mesothelioma.
Examples of Mesothelin-Targeted Therapies
Researchers are exploring how combining mesothelin-targeted therapies with checkpoint inhibitors like Opdivo and chemo may make treatment more effective. Early studies have shown that some combinations improve tumor response and may reduce the chances of cancer cells evading mesothelioma treatment.
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Find Your CenterPhotodynamic therapy uses a special drug that collects in cancer cells. A doctor then shines a laser light to turn the drug on and help kill the cancer. The activated drug kills the cells and can stop the cancer from spreading.
This treatment is promising because it causes few side effects. This means patients can have a better quality of life while getting treatment. Researchers tested low-dose photodynamic therapy (L-PDT) along with immunotherapy on mice. In mouse models, the results showed this treatment completely got rid of mesothelioma in 37.5% of the mice tested.
Vaccine Therapy
Cancer vaccines for mesothelioma train the immune system to recognize and attack tumor cells rather than prevent disease like traditional vaccines. These vaccines are designed to target proteins found specifically on mesothelioma cells, teaching immune cells to seek them out and destroy them.
The UV1 vaccine has shown good early results and earned fast-track status from the FDA. A recent study tested UV1 with Opdivo and Yervoy. It helped almost twice as many patients respond to treatment.
Studies of the galinpepimut-S vaccine also had positive results for people with mesothelioma. The GPS vaccine targets a protein called WT1 and stabilized cancer in one-third of patients, shrinking tumors 17%.
Virotherapy uses modified viruses to attack and kill mesothelioma cells. These viruses also help the immune system notice the cancer. Different types of virotherapy are being tested in clinical trials to see how well they work.
What is the future of mesothelioma treatment?
[MUSIC PLAYING] The future of mesothelioma treatment I really think
is going to be a multimodality approach. So surgery has always been the mainstay, followed by chemotherapy. But I do think immunotherapy and other targeted therapies towards proteins that are on the surfaces, basically, of mesothelioma cells are going to be the future.
So really, the idea is to make mesothelioma instead of a disease that thought to be instantly fatal, or such a poor prognosis, to make it into a chronic disease. You're never going to be able to get rid of it. We know that we can't cure it. But the idea is to live several years, if not longer, decades hopefully, eventually, with the disease, just keeping it at bay.
[MUSIC PLAYING]
What is the future of cancer treatment for mesothelioma?
[MUSIC PLAYING] The future of treatment for cancer, including mesothelioma, is really now. The FDA has a number of targeted therapies approved, as well as immunotherapy, and we’re finding, even in mesothelioma, many of these are effective for types of diseases that historically were difficult to treat. I still think surgery will have a role in helping patients feel better and live longer, but these adjuvant therapies, I really believe, are the future in sort of targeting patients’ individual tumors, harnessing the immune system to really attack a patient’s own tumor with less toxicity to the rest of their body. Even radiation of small tumor areas with certain drugs may actually have effects with other sites so that patients can get radiation that has a better treatment effect with a little more focused and less toxicity. So the future, I think, will be tailoring individual therapies for individual patients, really the selection of which therapies for which patient, and with less toxicity overall and better survival. [MUSIC PLAYING]
Multimodal therapy is a combination of already established treatments and emerging mesothelioma treatments. Some combinations that were once experimental are now often used for mesothelioma patients. For example, approved combinations now include Keytruda with chemo and TTFields with chemo, both now part of standard care.
Combining Emerging and Standard Therapies
Multimodal therapy reflects how far new mesothelioma treatments have come, combining once-experimental therapies into standard care. As more combinations earn FDA approval, patients have more options than ever. Ask your care team which combinations may be right for your diagnosis and overall health.
John Fiala
Mesothelioma Survivor Participates in Unique Clinical Trial
John Fiala joined a unique clinical trial using the immunotherapy combination of Opdivo (nivolumab) and Cyramza (ramucirumab). The treatment has enabled his immune system to fight the cancer in two different ways. Opdivo blocks a protein that often prevents the immune system from attacking tumors. Cyramza decreases the blood supply tumors need to metastasize.
John Fiala
Patients can access new mesothelioma treatments through clinical trials and specialized cancer centers. Joining a trial testing these treatments at a top cancer center requires meeting certain health and safety rules. Eligibility depends on cancer type, stage and health history.
Ways to Receive New Mesothelioma Therapies
Eligibility depends on cancer stage, tumor location, health and past treatments. Getting access to new treatment starts with the right care team. Working with a specialist or a Patient Advocate can help you find clinical trials that suit you. Patient Advocate Snehal Smart, MD, tells us, “Many patients ask us about clinical trials for new mesothelioma treatments. We can help guide them to these types of resources.”
Discover financial assistance programs, insurance guidance, and veteran benefits to help cover your mesothelioma treatment expenses.
Explore Your OptionsThe FDA must approve all new mesothelioma treatments before doctors can use them. This helps make sure the treatments are safe and work well. The process starts with lab tests and ends with a full FDA review.
FDA-Approval Process for Mesothelioma Therapies
The FDA may speed up this process for rare cancers like mesothelioma through Fast Track or Breakthrough Therapy designation. Even after approval, the FDA continues to check that the drug stays safe and works as expected.
Mesothelioma research extends beyond new drugs and therapies. Scientists are exploring how technology, surgical planning and nutrition may improve treatment outcomes. Some of the most promising findings come from unexpected places, including the natural compounds found in everyday foods.
Artificial Intelligence in Mesothelioma Research
Artificial intelligence is helping researchers find the best treatments and predict how individual patients will respond. A 2025 peer-reviewed study published in SAGE Journals found that AI and computer modeling can improve treatment planning for mesothelioma patients.
Surgical Technology Advances
Virtual reality is giving surgeons new tools to plan complex mesothelioma surgeries before entering the operating room. Mapping procedures in a virtual environment helps doctors anticipate challenges and improve results. Researchers are also exploring new ways to deliver medicines that are less painful and easier for patients.
Nutrition-Based Research
Diet and nutrition changes may help support mesothelioma treatment. Scientists have also studied capsaicin, a natural substance found in chili peppers, finding it may help stop mesothelioma cells from growing and moving. These findings come from early-stage lab research and capsaicin is not an approved treatment.
New mesothelioma treatments differ from standard ones because they’re still being tested. Emerging treatments like gene therapy build on the success of now-approved first-line treatments like immunotherapy and target cancer cells in new ways. Vaccine therapy builds on our understanding of how vaccines train the immune system, applying that knowledge to recognize and attack mesothelioma cells specifically.
People with mesothelioma may qualify for new treatments, depending on their cancer stage, type and health. It’s important to consider the benefits and risks of any treatment or trial. A mesothelioma doctor or Patient Advocate can help find the best trials for you.
Clinical trial sponsors fund new and emerging mesothelioma treatments during testing. Financial assistance options like travel grants, reimbursements and waivers can also help. Because asbestos exposure causes mesothelioma, patients may also be eligible for compensation from more than $30 billion in asbestos trust funds. A Patient Advocate can help you explore all available financial options alongside your treatment plan.
As of 2024, immunotherapy has been approved as a first-line treatment for pleural mesothelioma, with Opdivo and Yervoy approved as a combination. Keytruda combined with chemo and TTFields combined with chemo are also now standard approved treatments. Researchers continue to study targeted therapies, vaccine therapies and gene therapies in active clinical trials.
It can take years to get a mesothelioma treatment once it’s tested and FDA-approved. Safety must first be established through rigorous testing and evaluation. The FDA offers Fast Track and Breakthrough Therapy designations for treatments targeting rare cancers like mesothelioma, which can shorten the timeline to approval for the most promising therapies.
There is currently no cure for mesothelioma, though some patients achieve long-term remission with treatment. Researchers are actively working toward a cure through more than 80 active clinical trials testing new therapies. These trials give patients access to emerging treatments that may extend survival and improve quality of life.
Several new mesothelioma treatments are showing strong results in recent trials. Immunotherapy earned FDA approval as a first-line treatment for pleural mesothelioma in 2024, while the UV1 vaccine has earned FDA Fast Track status. Among the most closely watched findings, ATOMIC-Meso enzyme therapy helped more than half of patients whose cancer had stopped responding to standard treatment.
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Asbestos.com. "New Mesothelioma Treatments." Last modified March 9, 2026. https://www.asbestos.com/treatment/emerging-treatments/.
Karen Selby is a registered nurse and Board Certified Patient Advocate at The Mesothelioma Center with more than 30 years of experience in oncology and thoracic surgery. She worked as an operating room nurse in thoracic surgery at the University of Maryland for 6 years, assisting with surgeries such as lung transplants, pneumonectomies and pleurectomies. She later served as regional director of the tissue procurement program at the University of Florida. Karen joined The Mesothelioma Center in 2009, providing patients with personalized support and resources.
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