{"entity":{"id":"beat-meso","kind":"trial","name":"BEAT-meso (ETOP 13-18)","aka":[],"tldr":"Adding atezolizumab to bevacizumab-chemotherapy slowed progression but did not lengthen survival overall; it did help patients with non-epithelioid tumours.","summary":"BEAT-meso, ETOP trial 13-18, NCT03762018, sponsored by ETOP and reported at ASCO 2024, tested adding atezolizumab to bevacizumab plus carboplatin and pemetrexed as first-line treatment for advanced pleural mesothelioma, and found that it slowed progression but did not lengthen survival overall, though it did help patients with non-epithelioid tumours. It randomised 400 patients, missed its primary overall survival endpoint in the whole population, improved progression-free survival, and showed a survival benefit in the pre-specified non-epithelioid subgroup with a clear interaction by histology. OnCo links it to mesothelioma, atezolizumab, pemetrexed, the epithelioid versus sarcomatoid term and the ETOP IBCSG Partners Foundation, and the non-epithelioid finding echoes CheckMate 743. Whether histology should now decide who gets immunotherapy in mesothelioma is the open question.","status":"mixed","asOf":"2026-09-07","links":[{"label":"ClinicalTrials.gov NCT03762018","url":"https://clinicaltrials.gov/study/NCT03762018"},{"label":"ASCO 2024 LBA8002","url":"https://ascopubs.org/doi/10.1200/JCO.2024.42.17_suppl.LBA8002"}],"tags":[],"related":[],"cancers":["mesothelioma"],"sections":[],"technologies":["checkpoint-inhibitor"],"targets":[],"drugs":["atezolizumab","pemetrexed"],"companies":["etop-ibcsg"],"institutions":[],"pathways":[],"terms":["epithelioid-vs-sarcomatoid"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"nct":"NCT03762018","phase":"3","setting":"Advanced pleural mesothelioma, first line: bevacizumab + carboplatin-pemetrexed ± atezolizumab","sponsor":"ETOP","result":"OS not significantly improved overall; benefit in non-epithelioid subgroup.","started":"2019-04-30","startedType":"actual","yearReported":2024,"enrolled":400,"enrolledBasis":"registry","outcomes":[{"endpoint":"Overall survival","primary":true,"unit":"months","arms":[{"name":"Atezolizumab + bevacizumab + carboplatin-pemetrexed","n":200,"value":20.5,"note":"Not significant; primary endpoint not met"},{"name":"Bevacizumab + carboplatin-pemetrexed","n":200,"value":18.1}],"hr":0.84,"ci":[0.66,1.06],"p":"0.14","source":"https://doi.org/10.1016/j.annonc.2024.12.014"},{"endpoint":"Progression-free survival","unit":"months","arms":[{"name":"Atezolizumab + bevacizumab + carboplatin-pemetrexed","value":9.2},{"name":"Bevacizumab + carboplatin-pemetrexed","value":7.6}],"hr":0.72,"ci":[0.59,0.89],"p":"0.0021","source":"https://doi.org/10.1016/j.annonc.2024.12.014"},{"endpoint":"Overall survival, non-epithelioid histology","unit":"months","arms":[{"name":"Atezolizumab + bevacizumab + carboplatin-pemetrexed","note":"Pre-specified histology subgroup; interaction p = 0.012 (epithelioid HR 1.01, 95% CI 0.77-1.32)"},{"name":"Bevacizumab + carboplatin-pemetrexed"}],"hr":0.51,"ci":[0.32,0.8],"source":"https://doi.org/10.1016/j.annonc.2024.12.014"}],"replication":"Primary OS endpoint missed; the non-epithelioid benefit echoes CheckMate 743, where ipilimumab-nivolumab helped non-epithelioid disease most. Not independently replicated."},"route":"/trials/beat-meso/","neighbours":{"cancer":[{"id":"mesothelioma","kind":"cancer","name":"Mesothelioma","route":"/cancers/mesothelioma/"}],"technology":[{"id":"checkpoint-inhibitor","kind":"technology","name":"Immune checkpoint inhibitors","route":"/technologies/checkpoint-inhibitor/"}],"drug":[{"id":"atezolizumab","kind":"drug","name":"Atezolizumab","route":"/drugs/atezolizumab/"},{"id":"pemetrexed","kind":"drug","name":"Pemetrexed","route":"/drugs/pemetrexed/"}],"company":[{"id":"etop-ibcsg","kind":"company","name":"ETOP IBCSG Partners Foundation","route":"/companies/etop-ibcsg/"}],"term":[{"id":"epithelioid-vs-sarcomatoid","kind":"term","name":"Epithelioid vs sarcomatoid (biphasic) mesothelioma","route":"/terms/epithelioid-vs-sarcomatoid/"}]}}