Chemotherapy
Chemotherapy is a cancer treatment that uses cytotoxic drugs to kill rapidly dividing cancer cells or slow their growth. The standard first-line chemotherapy regimen for mesothelioma combines pemetrexed (Alimta) with cisplatin or carboplatin, typically administered in 21-day cycles for 4–6 cycles.
For decades, chemotherapy was the primary systemic treatment for mesothelioma. The combination of pemetrexed and cisplatin, approved in 2004, remains the backbone of first-line treatment. This regimen produces tumor response in approximately 40% of patients and has a median overall survival of 12–16 months.
Chemotherapy may be used as a standalone treatment for patients who are not surgical candidates, or as part of a multimodal approach combining it with surgery and radiation therapy. When used before surgery (neoadjuvant), chemotherapy aims to shrink the tumor. When used after surgery (adjuvant), it targets remaining cancer cells.
Since 2020, immunotherapy with nivolumab plus ipilimumab has been approved as an alternative first-line option, particularly for patients with sarcomatoid or biphasic cell types. Patients should discuss both chemotherapy and immunotherapy options with their oncologist to determine the best approach for their specific diagnosis. Learn more about treatment options.
- Also known as
- Chemo, Systemic chemotherapy
- Category
- Treatment
- Related terms
- Pemetrexed, Cisplatin, Immunotherapy, Radiation Therapy, Clinical Trial
What chemotherapy drugs are used for mesothelioma?
The standard first-line regimen combines pemetrexed (Alimta) with cisplatin or carboplatin, administered in 21-day cycles for 4 to 6 cycles.
How effective is chemotherapy for mesothelioma?
The pemetrexed-cisplatin combination produces tumor response in approximately 40% of patients, with a median overall survival of 12 to 16 months.
Is immunotherapy better than chemotherapy for mesothelioma?
For sarcomatoid and biphasic cell types, immunotherapy has shown superior survival. For epithelioid mesothelioma, both options remain viable first-line treatments.
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