Mesothelioma Clinical Trials

• Patients ≥18 years of age, with biopsy confirmed MPM and histological subtyping (epithelioid or non-epithelioid)

• N0 or N1 and M0 disease

• Written informed consent

• Patient and local/regional MDT opt for active surveillance and deferral of SACT until clinical or radiological progression

• WHO Performance Status 0-1

• Disease confined to one hemithorax based on CT assessment

• Adequate pulmonary function

‣ ≥ 40% predicted post-FEV1;

⁃ ≥ 40% predicted DLCO/TLCO

• Agreement to travel to either proton beam therapy centres (i.e. UCLH or The Christie) if randomised to arm 2

• Agreement to be followed up at a local HIT-Meso trial site

• Patient likely able to complete PBT planning based on local assessment