# Epithelioid vs sarcomatoid (biphasic) mesothelioma

Source: https://onco.cc/terms/epithelioid-vs-sarcomatoid/  
OnCo record `epithelioid-vs-sarcomatoid` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Mesothelioma comes in a slower 'epithelioid' form and an aggressive 'sarcomatoid' form. Chemotherapy works better in the first; immunotherapy helps most in the second.

## Summary

Epithelioid (~60-70%) has median survival 14-18 months with chemotherapy; sarcomatoid (~10-20%) and biphasic (~20%) respond poorly to chemotherapy (median OS 8-12 months) but derived the largest benefit from nivolumab-ipilimumab in CheckMate 743 (OS 18.1 vs 8.8 months) and from pembrolizumab-chemotherapy. Histology is therefore the first branch in first-line decisions. BAP1 loss is common in epithelioid tumours; CDKN2A/MTAP deletion in sarcomatoid.

## Fields

- Kind: Term
- Last checked: 2026-09-07

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Mesothelioma
- Wikipedia: https://en.wikipedia.org/wiki/Mesothelioma

## Connected records

- cancers: [Mesothelioma](https://onco.cc/cancers/mesothelioma/)
- trials: [BEAT-meso (ETOP 13-18)](https://onco.cc/trials/beat-meso/), [CheckMate 743](https://onco.cc/trials/checkmate-743/), [IND.227 / KEYNOTE-483](https://onco.cc/trials/keynote-483/)
- pairings: [Histology → first-line choice in mesothelioma](https://onco.cc/pairings/histology-directs-first-line-meso/)
- pathways: [Lineage plasticity & neuroendocrine transformation](https://onco.cc/pathways/lineage-plasticity-neuroendocrine/)

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