Defactinib is one of the most recently developed drugs used to fight mesothelioma. The stem cell-targeting drug has the potential to keep mesothelioma from returning after standard treatments.

Killing Mesothelioma Cancer Stem Cells

This trial was terminated and is no longer recruiting. The trial, alternately called COMMAND (Control of Mesothelioma with MAiNtenance Defactinib), evaluated the use of the new drug (defactinib) which targets mesothelioma stem cells. The purpose of the treatment is to prevent tumors from reappearing after the first rounds of chemotherapy with Alimta, cisplatin and other treatments. During this phase II trial, defactinib was unable to to prove effective enough to continue enrolling patients.

What to Expect

  • Defactinib
    Defactinib (VS-6063) – This is an experimental, orally administered drug. It is the only drug being evaluated in this clinical trial. Participants in the trial will take a 400 mg pill twice a day for as long as their disease does not progress.
  • Maintenance Therapy
    Maintenance Therapy – After cancer patients have their first rounds of treatment, whether that is surgery or chemotherapy, the next step is to prevent the cancer from spreading. This is the goal of defactinib.

If the trial had proven successful, COMMAND would have been the first maintenance treatment available to mesothelioma patients. Although it isn’t designed to kill off mesothelioma tumors, it may have allowed patients to live much longer by managing their disease. Defactinib is still being tested for other purposes.

Connect with Clinical Trials Now

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Unfortunately, this trial is no longer recruiting and was terminated. However, many more trials for mesothelioma are currently recruiting. Get in touch with us to learn more about clinical trials. Our patient advocates can help you find a clinical trial that fits your needs.

Clinical Trials Can Provide:
  • Exclusive access to promising new procedures.
  • One-on-one care from leading mesothelioma specialists.
  • Alternative options for patients who have exhausted traditional treatments.

How It Works

Treatment for mesothelioma is still far behind the treatments available for more common cancers. The use of a combination of the chemotherapy drugs Alimta and cisplatin has made a huge impact in the treatment of mesothelioma. However, mesothelioma tumors tend to come back in a more aggressive manner even after successful rounds of chemotherapy. Adding to the challenge is that these new tumors often develop a resistance to previously used chemotherapy drugs.

To date, there aren’t any treatments available that keep the mesothelioma tumors from returning and spreading. The use of defactinib could potentially fill the need for a maintenance therapy for mesothelioma patients.

Research conducted by Dr. Robert Weinberg found that mesothelioma often grows back after being treated with chemotherapy because the cancerous stem cells remain after treatment. Furthermore, these stem cells may be attributed to the disease’s acquired resistance to chemotherapy.

Defactinib is designed to block the signaling pathways that deliver nutrients to mesothelioma stem cells and starve them. The goal is to maintain the success of the initial treatments by preventing mesothelioma from growing back and spreading.

Who Is This Trial For?

This clinical trial is for pleural mesothelioma patients who wish to outlive their prognosis. There is no guarantee that this trial will work, but it could prevent tumors from growing back and metastasizing.

To be eligible, participants must:

  • Have received only one regimen of chemotherapy
  • Wait 6 weeks after last chemotherapy treatment
  • Wait at least 28 days after major surgery
  • Have a prognosis greater than 3 months

Getting Enrolled in This Trial

This trial is no longer recruiting. However, defactinib is still being tested for other uses, including mesothelioma treatment. If you are interested in participating in clinical trials, or simply learning more about them, we can help. Our team of patient advocates are experienced in helping patients enroll in trials that are likely to provide them with the greatest survival benefit. Get connected with clinical trials today.


The COMMAND trial of defactinib has study locations all around the world. There are studies taking place throughout North America, Europe and all the way in Japan. Below are the locations for the study in the United States.

  • Abramson Cancer Center

    Abramson Cancer Center

    Principal Investigator: Dr. Evan Alley
    Dr. Alley is an experienced medical oncologist leading the defactinib trial at Abramson Cancer Center. Standard treatment for mesothelioma only has limited effects currently, which is why Dr. Alley has said, “That’s why we’re looking for other better therapies.” Abramson is known for its extensive team of mesothelioma specialists as well as its success at treating the disease.

    University of Chicago Cancer Center

    University of Chicago Cancer Center

    Principal Investigator: Dr. Hedy Kindler
    Dr. Kindler sees more than 100 mesothelioma patients per year at the University of Chicago. Her experience has led her to understand that mesothelioma patients need far better treatments and that research into drugs like defactinib is the way to get there. “We need better drugs,” said Dr. Kindler. “We need more preclinical investigations. We need better designed trials.” The COMMAND trial of defactinib takes this all into account.

    Memorial Sloan Kettering Cancer Center

    Memorial Sloan Kettering Cancer Center

    Principal Investigator: Dr. Marjorie Zauderer
    Sloan-Kettering has one of the best mesothelioma teams in the country. Dr. Zauderer is an assistant physician with years of experience treating mesothelioma patients and researching the disease. She has conducted research in radiation and chemotherapy for mesothelioma, but her strongest interest is in novel treatments like defactinib.

    Cleveland Clinic

    Cleveland Clinic

    Principal Investigator: Dr. James Stevenson
    Dr. Stevenson is the chief of medical oncology at the Cleveland Clinic. He was formerly a part of the mesothelioma program at the Abramson Cancer Center, which is also conducting research on defactinib. He formed the mesothelioma program in Cleveland in part because of his belief that it’s beneficial to have more experienced treatment centers across the country for patients.

    Johns Hopkins Sidney Kimmel Comprehensive Cancer Center

    Johns Hopkins Sidney Kimmel Comprehensive Cancer Center

    Principal Investigator: Dr. Julie Brahmer
    Dr. Brahmer is an active clinical research investigator for mesothelioma. She has also placed a lot of importance on the physical and emotional quality of life her patients experience. Dr. Brahmer is also directing a clinical trial to uncover possible genetic causes of mesothelioma.

    UT Southwestern Simmons Cancer Center

    UT Southwestern Simmons Cancer Center

    Principal Investigator: Dr. Jonathan Dowell
    Dr. Dowell is another specialist active in mesothelioma research. He is the director of the mesothelioma program at UT Soutwestern in Dallas. Dr. Dowell has studied a multitude of novel therapies in mesothelioma. Defactinib is one of his most promising trials yet.