Mesothelioma Research and Clinical Trials

Pragmatic clinical trials and the development of representative patient cohorts

• ASSESS-meso: Europe's largest prospective, multicentre, longitudinal cohort study (https://bmjopen.bmj.com/content/12/11/e060850). The project aims to collect information on demographics, symptoms, and biomarkers from a representative UK mesothelioma population (https://publications.ersnet.org/content/erjor/9/6/00467-2023) to help characterise different disease phenotypes, build a bio-repository of serial blood and pleural fluid samples, and provide a resource for future trials.
  
  
• TILT Trial: an NIHR-funded feasibility study investigating intra-pleural bacterial immunotherapy. This trial utilised the highly pragmatic "Trial within a Cohort" (TwiC) methodology, that has informed the design of subsequent sub-studies within the ASSESS cohort, including research into pain (https://link.springer.com/article/10.1186/s12904-026-02187-w), mental health (https://www.sciencedirect.com/science/article/pii/S146238892400070X), and treatment decision making (https://pubmed.ncbi.nlm.nih.gov/35247743/) in people with mesothelioma.
  
  
• Biomarker Validation: This includes validating the use of the Ki67 proliferation index  (https://publications.ersnet.org/content/erjor/12/3/01300-2025)to augment tumour grading for better survival prediction in epithelioid mesothelioma. Research demonstrating that serial serum mesothelin (SM) measurements can reliably track disease status and predict progression (https://pubmed.ncbi.nlm.nih.gov/40683126/), potentially offering a cheaper, community-based alternative to CT scans.