What Are the Chemotherapy Options for Mesothelioma?
The standard and most effective first-line chemotherapy regimen for pleural mesothelioma patients is the combination of cisplatin and pemetrexed (Alimta). A related combination of pemetrexed and carboplatin often achieves the same results but with fewer side effects.
These drugs are usually delivered with an IV into the bloodstream. Sometimes, doctors heat up chemotherapy drugs and deliver them locally after surgery rather than throughout the bloodstream.
In a 2016 study, researchers at Wayne State University found mesothelioma patients who received one of the chemotherapy combinations survived three times longer than patients without chemotherapy.
If the cancer grows, patients may undergo second-line chemotherapy with other drugs, including:
- Carboplatin
- Gemcitabine
- Doxorubicin
Other chemotherapy drugs tested on mesothelioma have included onconase, navelbine, raltitrexed and mitomycin.
HIPEC
Heated Intraperitoneal Chemotherapy (HIPEC) is the most effective treatment option for peritoneal mesothelioma patients.
In this procedure, heated chemotherapy drugs are delivered directly into the abdominal cavity after cytoreductive surgery to kill remaining cancer cells.
According to a 2013 study at Moffitt Cancer Center in Tampa, Florida, the median survival rate for peritoneal patients who underwent HIPEC and cytoreductive surgery was 41 months. Those who returned for a second procedure survived an average of 80 months.
Intraperitoneal chemotherapy may also be administered without surgery and with the chemotherapy at normal room temperature.
Quick Fact:
75 percent of peritoneal mesothelioma patients survived at least five years after receiving three types of intraperitoneal chemotherapy: Normothermic intraperitoneal chemotherapy (NIPEC), HIPEC and early postoperative intraperitoneal chemotherapy (EPIC).
HITHOC
Hyperthermic intrathoracic chemotherapy (HITHOC) is an experimental version of HIPEC for people with pleural mesothelioma.
HITHOC delivers heated chemotherapy throughout the chest cavity after a pleurectomy and decortication.
Currently, HITHOC is not as successful as HIPEC, but doctors are optimistic the procedure can be improved. Several studies have reported longer survival among patients who received HITHOC.
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