Mesothelioma chemotherapy can help ease symptoms and prolong life, but many patients stop responding to treatment after some time. These patients may benefit from participating in clinical trials as promising second-line treatment options are currently under research.

Standard chemotherapy for mesothelioma can slow the growth of cancer cells and prevent them from spreading. The most widely-used chemotherapy intervention, pemetrexed (Alimta®) plus cisplatin, is the only FDA approved chemotherapy drug combination for mesothelioma treatment. It’s considered the standard first-line chemotherapy treatment option.

While chemotherapy can significantly improve survival for mesothelioma patients, about 60% of patients stop responding to treatment.

Understandably, this leaves patients feeling extremely hopeless. Since there is no approved second-line therapy for mesothelioma, patients who stop responding to treatment or who experience relapse must turn to palliative care or emerging therapies offered through clinical trials.

First-Line Chemotherapy for Mesothelioma

The medical community accepts the first-line therapy as the best treatment option for a particular disease. The first-line treatment for mesothelioma is a combination of two anti-cancer drugs: pemetrexed and cisplatin.

Pemetrexed, sold under the brand name, Alimta, reduces cancer cell multiplication by blocking certain substances in the body that help cells grow and replicate. Cisplatin works by damaging the DNA of cancer cells to stop their growth and encourage their death. Currently, the combination of these two drugs is the most proven drug intervention we have for mesothelioma.

The goal of first-line chemotherapy is to eliminate as many cancer cells as possible.

In mesothelioma patients, first-line chemotherapy tends to have positive results at first. For many people, however, chemotherapy eventually fails and they experience mesothelioma recurrence (when the cancer comes back).

No Approved Second-Line Therapy

Second-line therapies are given to patients when first-line treatments stop working. Unfortunately, the FDA has not approved a standard second-line treatment for mesothelioma. So far, no other treatment has been effective on enough mesothelioma patients to make it a standard second option.

While this sounds bleak, mesothelioma patients who stop responding to first-line chemotherapy still have options. Palliative care, for example, can help with pain management and improve the patient’s quality of life.

Mesothelioma patients can also participate in clinical trials to receive new treatments that are currently being researched.

Some chemotherapy drugs used to treat other cancers may be useful as a second-line therapy for mesothelioma patients. These drugs are currently being tested and are yet to be FDA approved for mesothelioma. One particular form of treatment, called immunotherapy, shows great promise as a second-line treatment. Research on immunotherapy is still in its early phases.

Emerging Immunotherapies for Mesothelioma

A lot of mesothelioma research is focused on uncovering an effective second-line treatment for patients who have relapsed. The hope is also to discover a more successful first-line treatment. Recent research suggests that immunotherapy could be help out in these areas.

Immunotherapy involves using drugs to encourage the patient’s immune system to target and destroy cancer cells.

Typically, the immune system fights bacteria and infections and protects healthy cells in the body. Since cancer cells often look like normal cells, the immune system has trouble recognizing them as a danger to the body. This one of cancer’s main defenses against our immune systems.

Immunotherapy drugs target specific proteins in the body that prevent our immune systems from attacking cancer cells. With these proteins blocked, the immune system is free to go after cancer cells. Essentially, immunotherapy releases the brakes on the immune system, allowing the body’s defense system to fight cancer on its own.

Recent research suggests that immunotherapy could be an extremely beneficial second-line treatment for mesothelioma.

Researchers in France conducted a recent study to test the immunotherapy drug combination of nivolumab plus ipilimumab. The study results were mostly positive. According to researchers, this drug combination could be promising for relapsed patients who have mesothelioma.

Hope for Relapsed Mesothelioma Patients

Immunotherapy research is providing hope to the mesothelioma community and victims of this tragic disease. If you’ve stopped responding to chemotherapy, talk to your mesothelioma specialist about the possibility of participating in clinical trials. This can open you up to new treatment options, including immunotherapy, that may help control your disease.

If you’ve been diagnosed with mesothelioma and have a history of asbestos exposure, you may be eligible to receive legal compensation. Financial compensation helps pay for ongoing treatments and gives you access to top therapies. Contact our Justice Support team today at (866) 608-8933 to take action.

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Laura WrightWritten by:

Lead Editor

Laura Wright is a journalist and content strategist with more than 15 years of professional experience. She attended college at the University of Florida, graduating magna cum laude with a bachelor’s degree in journalism in 2008. Her writing has been featured in The Gainesville Sun and other regional publications throughout Florida.

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  1. “Drugs Approved for Malignant Mesothelioma” National Cancer Institute. Retrieved from Accessed on March 9, 2019.

  2. “Chemotherapy treatment in malignant pleural mesothelioma: a difficult history” Journal of Thoracic Disease. Retrieved from Accessed on March 9, 2019.

  3. “Immunotherapy for Malignant Mesothelioma” American Cancer Society. Retrieved from Accessed on March 9, 2019.

  4. “Immunotherapy shows promise for mesothelioma” Canadian Cancer Society. Retrieved from Accessed on March 9, 2019.

  5. “Immunotherapy for malignant pleural mesothelioma: current status and future directions” Translational Lung Cancer Research. Retrieved from Accessed on March 9, 2019.

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