Mesothelioma is a rare disease with an overall survival rate of 1 year and a 5 year survival rate of about 10%. Recently, pembrolizumab in combination with pemetrexed and carboplatin was approved by FDA as the first-line treatment of metastatic non-squamous non-small cell lung cancer (NSCLC), irrespective of PD-L1 expression. This is a case of a 78 year old female diagnosed for 6 years with Malignant pleural epithelial mesothelioma extending to the peritoneum. This initially manifested as back pain with an ECOG performance status of 0. 2 months after diagnosis, patient was managed with Intensity-modulated radiation therapy(IMRT) for 1 month with no response. Patient then underwent pressurized intraperitoneal/intrathoracal aerosol chemotherapy (PIPAC/PITAC) with cisplatin and doxorubicin for 3 doses still with no response. She then enrolled on a clinical trial of LY3023414 at Memorial Sloan Kettering Cancer Center for 1 month. However, she withdrew from the trial and went back to the Philippines to try immunotherapy with pembrolizumab every 3 weeks. With disease progression after 1 year, patient was then given pemetrexed and carboplatin (pem/carbo) plus pembrolizumab every 21 days for 1 year until present. This is a rare case of a long tern survival of malignant mesothelioma for 6 years.