The malignant pleural mesothelioma (MPM) market is expected to experience consistent growth throughout the forecast period (2025–2034). The anticipated launch of innovative therapies from companies such as AstraZeneca, Polaris Pharmaceuticals, Amphera BV, RS Oncology, and others is projected to accelerate market expansion across the 7MM.
The malignant pleural mesothelioma market is anticipated to witness steady growth during the forecast timeframe (2025–2034). The introduction of novel treatment options by leading pharmaceutical and biotech companies, including AstraZeneca, Polaris Pharmaceuticals, Amphera BV, RS Oncology, and others, is expected to significantly contribute to market growth across the 7MM.
DelveInsight’s Malignant Pleural Mesothelioma Market Insights report offers an in-depth analysis of current treatment paradigms, emerging malignant pleural mesothelioma therapies, individual drug market shares, and historical as well as forecasted malignant pleural mesothelioma market size from 2020 to 2034 across the 7MM [the United States, EU4 (Germany, France, Italy, and Spain), the United Kingdom, and Japan].
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Malignant pleural mesothelioma (MPM) is a rare, aggressive malignancy originating from the mesothelial cells lining the pleura and is strongly linked to prolonged asbestos exposure. Characterized by rapid progression and poor prognosis, the disease predominantly affects older men several decades after initial exposure. Tumor heterogeneity contributes significantly to treatment resistance and complicates disease management.
To enhance diagnostic precision, the 2021 WHO Classification of Thoracic Tumors (IARC) updated disease terminology by replacing “diffuse malignant pleural mesothelioma” with “diffuse pleural mesothelioma” and “localized malignant pleural mesothelioma” with “localized pleural mesothelioma.”
Asbestos exposure remains the primary risk factor, causing chronic inflammation and cellular damage. Additional risk factors include exposure to erionite, prior radiation therapy, potential simian virus 40 involvement, genetic susceptibility—particularly BAP1 mutations—advanced age, and male gender.
Patients commonly present with symptoms such as chest pain and dyspnea due to pleural effusion or lung encasement. Systemic manifestations, including fatigue and weight loss, are often driven by cytokine-mediated processes. Some patients remain asymptomatic, emphasizing the importance of surveillance among high-risk populations.
Diagnosis relies on imaging modalities such as CT and PET scans, though histopathological confirmation remains the gold standard. Immunohistochemical markers assist in differentiating MPM from other malignancies, while biomarkers like mesothelin show potential but lack standalone diagnostic accuracy. Accurate staging, often involving invasive procedures, is critical for guiding treatment decisions and prognosis.
The epidemiology section of the malignant pleural mesothelioma report provides detailed insights into historical trends, current patient populations, and future projections across the 7MM. It evaluates disease burden by synthesizing data from published studies and expert opinions.
The epidemiological analysis for the period 2020–2034 includes segmentation by:
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Treatment of malignant pleural mesothelioma typically follows a multimodal strategy involving surgery, radiotherapy, and chemotherapy, with chemotherapy remaining the backbone of management. Surgical intervention is limited to a small subset of patients, while radiotherapy is primarily palliative. Standard chemotherapeutic agents include pemetrexed, cisplatin, carboplatin, and gemcitabine.
Therapies are categorized into first-line and subsequent lines based on disease progression and response. However, existing treatments are associated with significant limitations, including toxicity, resistance, and disease recurrence. Consequently, the development of targeted therapies and immunotherapies aims to improve survival outcomes.
KEYTRUDA (pembrolizumab), a PD-1 inhibitor, received U.S. FDA approval in September 2024 in combination with pemetrexed and platinum chemotherapy for first-line treatment of unresectable advanced or metastatic MPM, based on the KEYNOTE-483 trial. In November 2024, the EMA’s CHMP issued a positive opinion for its use in unresectable nonepithelioid MPM, with regulatory review ongoing in Japan.
Additionally, the combination of nivolumab and ipilimumab was approved by the U.S. FDA in October 2020 for first-line treatment of unresectable MPM following results from the CHECKMATE 743 trial. OPDIVO monotherapy also received approval in Japan in August 2018 for post-chemotherapy MPM patients based on the MERIT trial.
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Significant progress in understanding MPM pathophysiology has fueled the development of novel therapeutic strategies, including immunotherapies, gene therapies, and metabolic interventions. Companies such as AstraZeneca, Amphera BV, and PrECOG are advancing candidates through early- to mid-stage clinical development.
Volrustomig (MEDI5752) is a bispecific antibody targeting PD-1 and CTLA-4, designed to enhance anti-tumor immune activity while potentially minimizing toxicity. A Phase III trial is evaluating volrustomig in combination with carboplatin and pemetrexed in unresectable MPM, with outcomes expected after 2026.
Pegargiminase (ADI-PEG 20), an arginine-depleting enzyme therapy, is under evaluation in the Phase III ATOMIC-Meso trial. Positive survival data have prompted a rolling regulatory submission, with potential commercialization anticipated in 2025.
MesoPher, an autologous dendritic cell-based immunotherapy developed by Amphera BV, is currently in Phase III trials. Clinical results published in The Lancet Oncology (June 2024) demonstrated favorable immunogenicity and safety.
Other pipeline candidates include:
The anticipated approval and launch of these therapies are expected to substantially reshape the malignant pleural mesothelioma treatment landscape.
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The malignant pleural mesothelioma market is shaped by complex clinical, regulatory, and legal dynamics. Many patients benefit from asbestos-related legal compensation, improving access to high-cost therapies. Additionally, several pipeline therapies have received Orphan Drug Designation (ODD), offering regulatory and commercial incentives.
Advances in biomarker development are also supporting earlier diagnosis and personalized treatment approaches. Therapies demonstrating superior efficacy over existing standards may command premium pricing in this high-unmet-need market.
However, market growth may be constrained by late-stage diagnosis, limited survival benefits of standard therapies, declining disease incidence in most 7MM regions, pricing pressures, reimbursement challenges, and healthcare workforce limitations. These factors underscore the importance of demonstrating meaningful clinical value and cost-effectiveness.
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