A new clinical trial is giving hope to patients with mesothelioma, a rare and aggressive cancer caused by asbestos. For the first time, researchers have shown that a targeted drug can slow the disease's progression after other treatments have failed.
The trial, known as NERO, tested a drug called niraparib in 88 patients across the UK. Niraparib blocks cancer cells from repairing damaged DNA, which leads to their breakdown. Participants who received the drug saw a 27% reduction in the risk of their cancer worsening or causing death. On average, it delayed progression by about six weeks—significant in a cancer where treatment options are limited and outcomes are often poor.
The study also accounted for tumor subtype (epithelioid vs. non-epithelioid) and whether patients had previously responded to platinum-based chemotherapy. This allowed researchers to evaluate how well the drug worked across different types of patients, strengthening the validity of the findings. The most common side effects observed in the niraparib group were fatigue, nausea, and low blood counts, but these were considered manageable.
James Fox, an 83-year-old architect, was one of the trial participants. Diagnosed in 2018 and given a few months to live, he joined the study after exhausting other therapies. His cancer responded so well to niraparib that he continued to receive it. Now, he remains active—still working, still fishing, and spending time with his family.
Researchers are now analyzing patient tissue and blood samples to identify biomarkers that might predict who benefits most from this approach. They’re also developing AI tools to assess treatment effectiveness from scans, aiming to spot early signs of progress or failure. A follow-up trial, SELECTmeso, is already in development and will personalize treatment even further by matching patients with therapies based on the genetic characteristics of their tumors.
Mesothelioma remains incurable. But this study marks a step forward—and a reminder that even small gains can make a big difference.
Read the abstract here: https://pubmed.ncbi.nlm.nih.gov/37993149/
Read the University of Leicester News Release here: https://le.ac.uk/news/2025/april/asbestos-cancer-nero-leicester-fennell
