# BEAT-meso (ETOP 13-18)

Source: https://onco.cc/trials/beat-meso/  
OnCo record `beat-meso` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

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.

## Fields

- Kind: Trial
- Status: mixed
- Last checked: 2026-09-07
- Registry id: NCT03762018
- Phase: 3
- Setting: Advanced pleural mesothelioma, first line: bevacizumab + carboplatin-pemetrexed ± atezolizumab
- Sponsor: ETOP
- Enrolled: 400
- Result: OS not significantly improved overall; benefit in non-epithelioid subgroup.
- Outcomes: Overall survival: Atezolizumab + bevacizumab + carboplatin-pemetrexed 20.5 months vs Bevacizumab + carboplatin-pemetrexed 18.1 months, HR 0.84; Progression-free survival: Atezolizumab + bevacizumab + carboplatin-pemetrexed 9.2 months vs Bevacizumab + carboplatin-pemetrexed 7.6 months, HR 0.72; Overall survival, non-epithelioid histology: Atezolizumab + bevacizumab + carboplatin-pemetrexed vs Bevacizumab + carboplatin-pemetrexed, HR 0.51
- Replication: Primary OS endpoint missed; the non-epithelioid benefit echoes CheckMate 743, where ipilimumab-nivolumab helped non-epithelioid disease most. Not independently replicated.

## Sources

- ClinicalTrials.gov NCT03762018: https://clinicaltrials.gov/study/NCT03762018
- ASCO 2024 LBA8002: https://ascopubs.org/doi/10.1200/JCO.2024.42.17_suppl.LBA8002

## Connected records

- cancers: [Mesothelioma](https://onco.cc/cancers/mesothelioma/)
- technologies: [Immune checkpoint inhibitors](https://onco.cc/technologies/checkpoint-inhibitor/)
- drugs: [Atezolizumab](https://onco.cc/drugs/atezolizumab/), [Pemetrexed](https://onco.cc/drugs/pemetrexed/)
- companies: [ETOP IBCSG Partners Foundation](https://onco.cc/companies/etop-ibcsg/)
- terms: [Epithelioid vs sarcomatoid (biphasic) mesothelioma](https://onco.cc/terms/epithelioid-vs-sarcomatoid/)

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