Chemotherapy for Mesothelioma

How Does Chemotherapy Treat Mesothelioma?

Chemotherapy treats mesothelioma by killing cancer cells, which divide and multiply more quickly than most other cells in the body. Chemotherapy drugs damage cells while they divide. As a result, chemotherapy can slow the growth of or kill mesothelioma cancer cells.

Chemotherapy targets cancer cells but can also impact healthy cells. This means it often causes side effects, but it also extends survival for many mesothelioma patients. And mesothelioma researchers continue to look for ways to improve chemotherapy applications.

A mesothelioma treatment plan may include more than one chemotherapy drug. It may also combine chemotherapy with other therapy types, like surgery. Oncologists may use chemotherapy to provide two different types of care:

• Therapeutic care: Therapeutic treatments aim to improve the patient’s health and survival.
• Palliative care: Palliative treatments are intended to manage mesothelioma symptoms and improve the patient’s quality of life.

A mesothelioma doctor can determine if a patient may benefit from chemotherapy. For some mesothelioma patients, chemotherapy may extend survival time and improve quality of life.

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Types of Chemotherapy for Mesothelioma

Chemotherapy medications come in different types, and doctors may administer them in different ways. Patients may be more familiar with chemotherapy that circulates throughout the body (systemic therapy). Chemotherapy may also be confined to a specific location in the body (local chemotherapy).

Treatment plans may include several types of chemotherapy drugs for malignant mesothelioma. They may also include both systemic and local chemotherapy.

Types of Local Chemotherapy for Mesothelioma

In general, tumor location impacts which localized chemotherapy methods are available to mesothelioma patients. These methods also vary by the temperature and type of chemotherapy drugs given. Doctors often use these chemo methods to help kill cancer cells left behind after performing surgery. Common types of local mesothelioma chemotherapy include heated intraperitoneal chemotherapy (HIPEC) and heated intrathoracic chemotherapy (HITHOC).

HIPEC is heated chemotherapy for peritoneal mesothelioma. It is administered within the lower abdomen (peritoneal cavity). In general, doctors combine HIPEC with an abdominal surgery called cytoreductive surgery (CRS). The combination of HIPEC after surgery is considered the gold standard in treating peritoneal mesothelioma. Multiple studies have reported long-term survival of patients who received this treatment.

HITHOC is heated chemotherapy for pleural mesothelioma. It is administered within the chest (thoracic cavity). Doctors often combine HITHOC with surgery for more effective treatment. For example, it may follow surgery that removes the lining around the lung and potentially the affected lung. Several studies have reported extended survival in patients who received HITHOC plus surgery.

Mesothelioma treatment plans that include HIPEC or HITHOC have helped extend survival for many patients. Sometimes, neither of these methods are right for a patient. In these cases, doctors can recommend other types of treatment.

Other Types of Local Chemotherapy for Mesothelioma

Doctors may also recommend other types of local intracavitary chemotherapy for mesothelioma. They can explain eligibility requirements and potential risks and benefits.

Researchers continue to test new applications of chemotherapy in mesothelioma clinical trials.

Did You Know? HIPEC is a specialized mesothelioma treatment only available at select cancer centers. Get help connecting with a cancer center that offers HIPEC to ensure you receive the best treatment possible. Locate a Top Mesothelioma Cancer Center Near You

Mesothelioma Chemotherapy Drugs

Doctors may use a number of different chemotherapy drugs to treat mesothelioma. The U.S. Food and Drug Administration (FDA) has approved Alimta® (pemetrexed) plus cisplatin to treat pleural mesothelioma. Studies have tested other chemotherapy medications to explore their potential mesothelioma treatment applications.

Researchers have looked into using systemic Alimta + cisplatin to treat peritoneal mesothelioma. They found it may extend survival for some peritoneal mesothelioma patients. But CRS and HIPEC extend survival further.

Chemotherapy drugs that may be used to treat mesothelioma include:

• Alimta® (pemetrexed)
• Cisplatin
• Doxorubicin
• Eloxatin® (oxaliplatin)
• Epirubicin
• Gemcitabine
• Irinotecan
• Mitomycin C
• Navelbine® (vinorelbine)
• Paclitaxel
• Paraplatin® (carboplatin)

Although similar, there are slight differences in how each chemotherapy drug works. As a result, they have their own potential benefits and side effects. Oncologists can recommend appropriate chemotherapy drugs and other mesothelioma cancer drugs based on individual patient cases.

Alimta (Pemetrexed)

Pemetrexed is a common chemotherapy drug for mesothelioma. Mesothelioma patients may be given the brands Alimta® or Pemfexy®. Pemetrexed is FDA-approved for pleural mesothelioma in combination with cisplatin. Doctors may also combine pemetrexed with carboplatin. Some studies and clinical trials found Alimta and cisplatin extended pleural mesothelioma patient survival to about 12 to 15 months.

Cisplatin

Cisplatin is a common, platinum-based mesothelioma chemotherapy drug. Patients whose tumors cannot be surgically removed may receive cisplatin. In combination with Alimta, cisplatin is FDA-approved to treat pleural mesothelioma. In studies, patient survival with this combination was between 12 and 15 months.

Carboplatin

Carboplatin is a platinum-based chemotherapy drug similar to cisplatin. It may also be referred to by its brand name, Paraplatin. Carboplatin may be a gentler option than cisplatin, with fewer side effects. In a study, pleural mesothelioma patients treated with Alimta and carboplatin had a median survival of about 13 months.

Other Mesothelioma Chemotherapy Drugs

In some cases, doctors may recommend chemotherapy drugs other than Alimta, cisplatin and carboplatin. These are less common but may be appropriate for some mesothelioma patients. Patients can discuss chemotherapy drug questions with their healthcare team.

• Gemcitabine: FDA-approved for various cancers, not mesothelioma, but doctors may still use it to treat certain mesothelioma patients. One pleural mesothelioma study used gemcitabine along with surgery and cisplatin. It reported survival from about 18 to 39 months.
• Navelbine (vinorelbine): Common chemotherapy drug for a common lung cancer type, but some mesothelioma researchers have used it. One study treated pleural mesothelioma patients with first-line, single-agent vinorelbine. The median survival was about 14 months.

Other chemotherapy drugs have sometimes been used to treat mesothelioma. These drugs include doxorubicin, Eloxatin and paclitaxel. Patients can discuss chemotherapy drug questions with their care teams.

Questions About Mesothelioma Chemotherapy Drugs? Ask experienced mesothelioma advocate Jennifer Lucarelli Ask a Question

Chemotherapy Treatment Plans for Malignant Mesothelioma

Mesothelioma patients may receive chemotherapy alone or in combination with other treatments. Plans involving two or more methods are called multimodal treatment plans. Doctors create personalized plans for patients based on their diagnosis and other factors like patient health.

The timing of chemo in relation to other treatments may differ between multimodal plans. Patients receiving multimodal treatment may hear different terms about the timing of their therapies. These terms relate to the different purposes of each therapy in the overall treatment plan.

Combining Chemotherapy With Other Mesothelioma Treatments

When part of a multimodal plan, doctors may combine chemo with various other methods. Chemotherapy may be combined with surgery, immunotherapy or Tumor Treating Fields (TTFields).

A notable multimodal study used repeated rounds of CRS and HIPEC to treat peritoneal mesothelioma patients. This combination of surgery and chemotherapy extended patient survival from 27.2 months to 80 months.

Patients may also receive chemotherapy after treatment with checkpoint inhibitors. Checkpoint inhibitors are a type of immunotherapy that help a patient’s immune system to fight cancer. The FDA has approved a combination of two checkpoint inhibitors, Opdivo® (nivolumab) and Yervoy® (ipilimumab), to treat pleural mesothelioma.

A patient’s mesothelioma doctor can recommend a custom-tailored treatment plan. This may include one treatment method or a combination of different methods. Factors such as overall health, mesothelioma stage and type may impact treatment options.

What to Expect When Receiving Mesothelioma Chemotherapy

Each patient’s experience with mesothelioma chemotherapy may be slightly different. But individuals can keep in mind some general expectations about common practices, procedures and side effects. Patients can speak with their care teams about the details of their specific plans.

A patient’s care team can explain the mesothelioma chemo process for local or systemic methods. They can also answer questions about how to prepare for the appointment. These specifics may vary depending on treatment details, such as which chemotherapy drug is given and how.

Side effects can vary from patient to patient. A patient’s care team can help them understand possible side effects and what to expect.

Some common side effects, such as nausea and vomiting, may affect patients’ mental health. Patients can find support from their care team for these challenges as well. Many cancer centers offer dedicated support services for emotional and mental well-being, like support groups.

How Many Chemo Treatments Are Needed for Mesothelioma?

The number of mesothelioma chemotherapy treatment cycles varies by patient. It depends on the patient’s case and other parts of their treatment plan.

Doctors may recommend multiple chemotherapy cycles, if appropriate for patients. For example, some mesothelioma patients have received six cycles or more of Alimta and cisplatin.

Patients can speak with their care team to understand what their experience may be like. This may help patients and their teams better navigate the treatment.

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How Effective Is Chemotherapy for Mesothelioma?

For some patients, chemotherapy may extend mesothelioma life expectancy. In general, malignant mesothelioma survival after chemotherapy ranges from one to five years. Various factors can impact a patient’s mesothelioma prognosis. These factors include chemotherapy method, tumor location and any other treatments.

Several studies have reported the effects of chemotherapy on mesothelioma survival.

A mesothelioma doctor can explain what a patient can expect for their individual case.

Can Chemotherapy Cure Mesothelioma?

Although chemotherapy cannot cure malignant mesothelioma, it may provide important benefits to patients. For some patients, chemotherapy may ease cancer symptoms and improve their quality of life. It may also extend survival in some cases.

Oncologists sometimes use chemotherapy in combination treatment plans. Research suggests combination plans may be more effective than single therapies at extending survival. Some experts say multimodal treatment is the best chance for a mesothelioma cure.

Researchers continue to look for more effective treatment options in mesothelioma clinical trials.

Chemotherapy Clinical Trials

Mesothelioma researchers continue to use clinical trials to study ways to improve chemotherapy’s effectiveness. Many ongoing clinical trials incorporate immunotherapy. Immunotherapy has improved life expectancy and helped manage side effects in mesothelioma patients.

Examples of ongoing mesothelioma chemotherapy clinical trials include:

• Chemotherapy, Avastin® (bevacizumab), Tecentriq® (atezolizumab): This trial treats peritoneal mesothelioma with a combination of chemo and a targeted therapy with and without an immunotherapy drug. These types of combination treatments have helped extend survival for many participants. As of August 2025, it was actively recruiting eligible patients to join.
• Dual checkpoint inhibitors with either chemo or immunotherapy drugs: This trial treats pleural mesothelioma with various potential drug combinations. One group will receive a new dual checkpoint inhibitor with standard chemo. The other group will receive either standard chemo or Opdivo with Yervoy immunotherapy. These types of combination treatments have shown promising survival rates in studies. As of August 2025, eligible patients could seek to join the trial.

Some of these clinical trials are being conducted outside the United States. American patients may not be eligible to participate in those trials. But results can still provide valuable information for the mesothelioma community. American patients can ask their doctors if they are eligible for United States trials.

What Are the Side Effects of Chemotherapy for Mesothelioma?

A mesothelioma chemotherapy regimen may lead to a variety of side effects. These can vary based on the type of chemotherapy drugs used. Systemic and intracavitary mesothelioma may also have different side effects. Some mesothelioma chemotherapy side effects are more common than others.

For example, patients may experience cognitive problems both during and after chemotherapy. These cognitive problems, also called chemo brain, include memory issues and trouble concentrating.

There may be other side effects associated with intracavitary chemotherapy. These side effects vary across the different types of intracavitary chemo.

Patients should discuss any side effects with their doctors. This includes new side effects or changes to existing treatment side effects. There may be ways to help manage these discomforts during treatment. In other cases, doctors may pause or end treatment. Care teams can also support patients if their mental health suffers during this time.

Who Is Eligible for Mesothelioma Chemotherapy?

The eligibility criteria for mesothelioma chemotherapy are specific. These criteria vary for systemic chemotherapy and intracavitary chemotherapy. Doctors can explain these options further. They can also recommend which chemotherapy medications, if any, may be appropriate for their patients.

In general, patients with inoperable pleural mesothelioma may be eligible for systemic chemotherapy. Patients with other forms of inoperable mesothelioma may also be eligible.

Patients with operable pleural or peritoneal mesothelioma may be eligible for intracavitary chemotherapy. For these patients, doctors may use a form of local chemotherapy before or after surgery. Depending on various factors, the appropriate chemotherapy could be HIPEC, HITHOC or PIPAC.

Chemotherapy may not be the right option for some patients. If so, their doctors can recommend other treatment options that may work better.