What to Know About Chemotherapy for Malignant Mesothelioma

Chemotherapy is the use of drugs to kill cancer cells. For this treatment, you will see a medical oncologist. This is a doctor who specializes in using drugs to treat cancer. For malignant mesothelioma, your doctor may give you more than 1 drug. This is called combination chemotherapy.

Chemotherapy may be your main treatment. You may get it before surgery to shrink the tumor. Or you may get it after surgery or radiation therapy to try to kill leftover cancer cells. You may also get it as part of a clinical trial in the operating room after an operation.

Most people with malignant mesothelioma have chemotherapy in an outpatient part of the hospital, at the doctor's office, or at home. In some cases, depending on your health or the drugs you take, you may need to stay in the hospital during treatment.

The doctor may give you chemotherapy as a pill or in your veins via an intravenous line (IV). Then, it's delivered to your entire body, which is systemic treatment. You may also get chemotherapy directly into your chest or abdomen. In that case, it's local treatment.

Doctors give chemotherapy in cycles. This means you will switch off between chemotherapy treatments and rest periods. Each treatment and rest period make up 1 cycle. You'll likely have more than 1 cycle of treatment.

Several chemotherapy regimens are in common use to treat mesotheliomas today. Most common is a combination of pemetrexed and cisplatin. Because pemetrexed interferes with levels of folic acid and vitamin B12 in the body, you will need to take supplements of these 2 vitamins in order to avoid certain side effects.

Other chemotherapy drugs used to treat mesothelioma include:

  • Gemcitabine

  • Carboplatin

  • Methotrexate

  • Vincristine

  • Vinblastine

  • Mitomycin

  • Doxorubicin

  • Epirubicin

  • Cyclophosphamide

  • Ifosfamide

Chemotherapy for malignant mesothelioma is usually given in combinations of 2 or more of these drugs. However, some people are unable to tolerate chemotherapy combinations so a single drug may be used. In addition to the drugs listed here, there are several other drugs under investigation to determine their effectiveness in treating mesothelioma. 

Your doctor will explain what your treatment plan will be and what you can expect. The length of each treatment period differs depending on the type of drug you take. With many types of chemotherapy, monthly treatments are common. Sometimes you may get chemotherapy more often.