A commentary commends the authors for their effort in conducting a large trial in patients with this rare disease and courage in attempting to fill a clearly unmet medical need with a new therapeutic strategy. It notes that the trial rationale was based on in-vitro data; data from a mouse xenograft model of a human epithelioid mesothelioma line, and a phase 1 trial reporting disease stabilisation lasting more than 4 months in 4 of 13 patients with mesothelioma who received vorinostat. The authors suggest that with the benefit of hindsight these data were insufficient to instigate a phase 3 trial, however, the study does raises awareness about the relevance and predictivity of preclinical outcomes, which is seldom addressed.