Northwestern Medicine Robert H. Lurie Comprehensive Cancer Center

When a patient in the Midwest receives a diagnosis of pleural mesothelioma or advanced lung cancer, one of the first referrals their oncologist is likely to make is to the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, located in Chicago, Illinois. It's one of the oldest and most respected cancer research institutions in the country, and it sits at the intersection of clinical care, laboratory science, and patient advocacy in ways that matter directly to people facing asbestos-related disease.

The Lurie Cancer Center holds a Comprehensive Cancer Center designation from the National Cancer Institute (NCI), a status that fewer than 53 institutions in the United States have earned as of 2024. According to the NCI, comprehensive designation requires demonstrated excellence in laboratory, clinical, and population-based research, as well as a commitment to community outreach and education. Northwestern's center first received NCI designation in 1974, making it one of the founding members of that network.

For patients with mesothelioma or asbestos-related lung cancer, the center's Thoracic Oncology Program offers multidisciplinary evaluation, meaning surgeons, medical oncologists, radiation oncologists, and pathologists review each case together. This team-based approach is widely considered the standard of care for rare and complex thoracic malignancies, where no single specialist can adequately address every treatment dimension alone.

The center is physically located on Northwestern's Chicago campus in Streeterville, integrated with Northwestern Memorial Hospital, one of the top-ranked hospitals in Illinois according to U.S. News and World Report's 2023-2024 rankings. That physical and institutional integration means patients don't have to travel between disconnected facilities to receive surgery, chemotherapy, and radiation. Their care happens, largely, under one roof and within one coordinated system.

The Lurie Cancer Center's diagnostic capabilities for thoracic malignancies, including pleural mesothelioma and peritoneal mesothelioma, reflect the full resources of a major academic medical center. Diagnosing mesothelioma is notoriously difficult. The disease mimics other conditions on imaging, and tissue sampling requires careful technique to preserve enough material for the specialized immunohistochemical staining that distinguishes mesothelioma from adenocarcinoma or other pleural tumors.

At Lurie, pathologists with subspecialty expertise in thoracic and pleural disease review biopsy specimens. According to the NCI, accurate pathologic diagnosis is the essential first step before any treatment planning, and errors at this stage can lead to months of inappropriate therapy. The center uses advanced molecular profiling tools, including next-generation sequencing (NGS), to characterize tumor genetics. For mesothelioma patients, this profiling can identify mutations in genes such as BAP1, CDKN2A, and NF2, which have implications for prognosis and eligibility for targeted therapies or clinical trials.

Imaging at Lurie includes positron emission tomography combined with computed tomography (PET-CT), which the American Cancer Society notes is valuable for staging mesothelioma and identifying lymph node involvement or distant spread. Endobronchial ultrasound (EBUS) and navigational bronchoscopy allow minimally invasive tissue sampling from thoracic lymph nodes and peripheral lung lesions. For suspected peritoneal mesothelioma, diagnostic laparoscopy may be performed to assess the extent of abdominal involvement before cytoreductive surgery is considered.

Imagine you've just been told you have epithelioid pleural mesothelioma at stage II. Your local oncologist has seen perhaps two cases in a career. The Lurie Cancer Center's Thoracic Oncology Program, by contrast, concentrates these cases across a regional and national referral base, giving its specialists a depth of experience that community oncologists simply can't replicate with a rare disease affecting roughly 3,000 Americans per year, according to the American Cancer Society.

Treatment at Lurie for mesothelioma typically follows a multimodal approach when the disease is identified at a resectable stage. This can include surgery, systemic chemotherapy, and radiation therapy, sequenced based on the individual patient's tumor histology, stage, and performance status. The center performs both extrapleural pneumonectomy (EPP) and the less radical pleurectomy with decortication (P/D), with the choice guided by tumor extent and lung function testing. According to a 2021 review published in the Journal of Thoracic Oncology, P/D has increasingly been favored at experienced centers because it preserves the underlying lung while still achieving macroscopic complete resection.

For patients with unresectable disease, which represents the majority of mesothelioma presentations, Lurie offers systemic therapy including the combination of cisplatin and pemetrexed (Alimta), which remains the standard first-line regimen per NCI guidelines. Since 2020, the CheckMate 743 trial results published in The Lancet established nivolumab plus ipilimumab as a viable first-line immunotherapy option, and Lurie's medical oncologists incorporate this regimen for appropriate patients, particularly those with non-epithelioid histology where chemotherapy response rates are lower.

The center also participates in clinical trials evaluating novel agents, including CAR-T cell therapies targeting mesothelin, a protein highly expressed on mesothelioma cells, as well as antibody-drug conjugates and combination immunotherapy regimens. Access to trials is one of the most tangible benefits of receiving care at an NCI-designated comprehensive center. According to the NCI's own data, patients enrolled in clinical trials at comprehensive cancer centers often gain access to therapies 5 to 10 years before they become standard of care, if they become standard at all.

Radiation therapy at Lurie utilizes intensity-modulated radiation therapy (IMRT) and image-guided techniques that allow high doses to be delivered to pleural surfaces while minimizing exposure to the heart, remaining lung, liver, and spinal cord. For patients who have undergone EPP, hemithoracic radiation is sometimes used as adjuvant therapy to reduce local recurrence risk, though its survival benefit remains under study.

Prognosis for mesothelioma patients treated at high-volume academic centers like Lurie generally reflects the disease's overall trajectory, but with meaningful differences at the margins. According to the NCI's SEER database, the five-year relative survival rate for pleural mesothelioma across all stages is approximately 12 percent. However, patients with early-stage epithelioid mesothelioma who undergo complete surgical resection at experienced centers have reported median survival times of 20 to 30 months or longer in retrospective series, substantially better than the population-wide median of roughly 18 months.

The Lurie Cancer Center's involvement in translational research means that prognostic biomarkers are actively studied. BAP1 loss, identified through immunohistochemistry on tumor tissue, is associated with a worse prognosis in pleural mesothelioma, while BAP1 germline mutations paradoxically appear linked to longer survival in some analyses, as reported in a 2016 study in JAMA Oncology by Pastorino and colleagues. Understanding these molecular nuances allows Lurie clinicians to give patients more individualized prognostic information rather than population averages alone.

Palliative care is integrated into the treatment model at Lurie, reflecting evidence from a landmark 2010 study published in the New England Journal of Medicine by Temel and colleagues showing that early palliative care integration improves both quality of life and, in some cancers, overall survival. For mesothelioma patients, symptom management including control of pleural effusion, pain, and dyspnea is as important as tumor-directed treatment, and Lurie's palliative care team works alongside the thoracic oncology group throughout the disease course.

Receiving care at a major academic cancer center like Lurie doesn't end when you leave the clinic. The center maintains survivorship programs, social work services, and patient navigation resources specifically designed for people managing complex diagnoses like mesothelioma. Patient navigators, a role the American Cancer Society has championed since the 1990s, help coordinate appointments across specialties, connect patients with financial assistance programs, and ensure that nothing falls through the cracks during transitions between surgery, chemotherapy, and follow-up imaging.

For patients traveling from outside the Chicago area, Northwestern Medicine offers guidance on lodging, transportation, and telemedicine options for follow-up visits that don't require in-person attendance. Many mesothelioma patients at Lurie have their initial evaluation and surgical planning done in Chicago, then work with local oncologists for ongoing chemotherapy infusions, with periodic check-ins at Lurie for imaging review and clinical trial monitoring. This hybrid model makes specialized care accessible without requiring relocation.

Support groups for mesothelioma patients and their families are available through the center and through affiliated organizations. The Mesothelioma Applied Research Foundation maintains a network of support resources and can connect patients with others who have been treated at centers including Lurie. Connecting with other patients who've navigated the same system, the same waiting rooms, and the same difficult conversations can be as valuable as any clinical resource.