Australia has the second highest incidence and death rate for malignant pleural mesothelioma (MPM). Standard first-line chemotherapy for MPM consists of cisplatin and pemetrexed. The majority of patients that do not respond to first-line therapy develop disease progression once treatment is stopped, and there is no accepted or approved second-line treatment. This means that there is a strong unmet clinical need for improving first-line therapy in MPM, and the DREAM study, led by Professor Anna Nowak, aims to do this.

DREAM is a Phase II trial of the anti-programmed cell death ligand-1 (PD-L1) checkpoint inhibitor, durvalumab, combined with the standard first-line chemotherapy currently used in MPM. The study opened to recruitment in December 2016 and concluded enrolment in September 2017, eight months ahead of schedule, with participants enrolled from ten centres across Australia. Professor Nowak presented the early data from DREAM highlighting the benefits of combined therapy applications for patients with MPM at the American Society for Clinical Oncology (ASCO) Congress in Chicago in June 2018. A follow-up Phase III DREAM trial is being planned.

See ANZCTR for full trial details >

Trial results published in The Lancet, September 2020 >


Trial Summary:

A phase 2 trial of durvalumab with first line chemotherapy in mesothelioma with a safety run in.

Supported By:

Astra Zeneca, National Centre for Asbestos Related Diseases (NCARD) Perth


Adults commencing first-line doublet chemotherapy with cisplatin and pemetrexed for Malignant Pleural Mesothelioma.

Registration ID:




Australian Lead Group:




Activation Date:



Prof Anna Nowak