Researchers are reporting promising results for people with mesothelioma who can have surgery. One researcher tested immunotherapy before and after surgery while the other researcher studied a blood test that helps doctors detect mesothelioma earlier than scans. Doctors at several cancer centers, including Johns Hopkins, ran an early clinical trial testing immunotherapy for mesothelioma. Patients were given Opdivo (nivolumab) alone or with Yervoy (ipilimumab) before surgery. After surgery, doctors gave Opdivo again. It was confirmed that this approach to mesothelioma is safe. Early results suggest giving immunotherapy before mesothelioma surgery may help patients live longer. The blood test at Georgetown University looks for mesothelioma tumor DNA in the bloodstream. Doctors are able to track how mesothelioma responds to treatment and identify patients at higher risk of the disease returning. Patients whose DNA levels dropped after therapy lived longer. Together these studies give doctors new ways to plan mesothelioma treatment and monitor the disease. This could allow patients to have their care personalized by doctors, giving more time with their loved ones.
The phase II clinical trial tested perioperative (pre-surgical) immunotherapy for people with mesothelioma whose tumors could be removed surgically. More than 80 percent of patients were able to have surgery on schedule after receiving pre-surgical immunotherapy. Each patient was monitored closely by doctors to track treatment response and adjust follow up care. The study wanted to find out if giving immunotherapy before surgery could help the immune system fight mesothelioma more effectively. Early results showed some patients lived longer than expected compared to historical outcomes, and the treatment was reported to be well tolerated. The results are only preliminary, but they suggest pre-surgical immunotherapy could provide meaningful results for some people with mesothelioma. This could lead to more studies that help doctors tailor to individual patients and could improve both survival and quality of life. The study was run at multiple cancer centers including Johns Hopkins and Georgetown University. They enrolled people with operable diffuse pleural mesothelioma, which means their cancer spreads widely across the lung lining. They measured survival, treatment tolerance, and if surgery can be done safely. Doctors used this information to understand who might benefit most from combining surgery with immunotherapy.
Researchers tested a highly sensitive blood test that looks for circulating tumor DNA (ctDNA), which are tiny fragments of tumors that are shed into the bloodstream. This test reads the genetic material of these fragments to find mesothelioma cells too small to see on scans. The low mutation rate of mesothelioma tumors makes it hard to detect ctDNA, but tracking ctDNA in the blood allowed doctors to monitor how the cancer changed over time and to see what treatments were working. Patients whose ctDNA levels dropped significantly or became undetectable after therapy tended to have better outcomes. The test also helped identify patients likely to experience mesothelioma recurrence, even when scans appeared normal. Early detection could let doctors adjust treatment sooner, potentially improving survival and quality of life. Georgetown University Medical Center researchers published the study on September 11, 2025. Doctors and their team tracked ctDNA changes in patients with mesothelioma. They were able to detect tiny traces of cancer that imaging scans missed and used the results to track how treatment was being responded to. These findings give doctors new tools to act sooner and offer patients more personalized care, bringing hope for better outcomes in the future.
