Pleural Mesothelioma Chemotherapy

What Is Pleural Mesothelioma Chemotherapy?

Chemotherapy for pleural mesothelioma is a type of cancer-killing treatment. The goal is to attack cancer cells by preventing cell division, replication and growth.

When malignant pleural mesothelioma forms, diseased mesothelial cells grow and spread rapidly, starting in the thin lining around the lungs (the pleura). Chemotherapy drugs can target the diseased cells, killing them and extending the patient’s life.

Chemotherapy involves delivering cytotoxic (anti-cancer) drugs, or chemicals, into the body. In pleural mesothelioma treatment, it is most often administered intravenously, through an IV drip. This type is also called systemic chemotherapy.

The chemotherapy drugs travel through the bloodstream to areas of the body where cancer cells are developing. Chemotherapy interferes with the diseased cells’ ability to replicate and causes them to die.

Patients typically receive pleural mesothelioma chemotherapy at a local hospital, cancer center, outpatient medical clinic or infusion center. Chemotherapy is the most accessible pleural mesothelioma treatment.

Hyperthermic Intrathoracic Chemotherapy (HITHOC) for Pleural Mesothelioma

Hyperthermic intrathoracic chemotherapy, also known as HITHOC or heated chemotherapy, is a type of chemotherapy involving heated liquid chemotherapy drugs. Mesothelioma treatment specialists use a mixture of heated chemotherapy drugs to bathe the thoracic cavity during surgery.

HITHOC is different from the standard method of delivering chemotherapy through an IV. Heated chemotherapy is delivered through tubing placed directly into the chest cavity, which gives the chemotherapy drugs direct access to the diseased tissue. The goal is to fill the chest cavity with heated chemotherapy, destroying any remaining mesothelioma cells not removed during surgery.

HITHOC’s delivery method minimizes the amount of chemotherapy entering the bloodstream and traveling to other parts of the body. This benefits patients by reducing the risk of chemotherapy attacking healthy tissue or blood cells, which can cause ongoing side effects such as nausea and fatigue.

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FDA-Approved Chemotherapy for Pleural Mesothelioma

Chemotherapy for pleural mesothelioma was approved by the FDA in 2004. Pemetrexed and cisplatin are the two drugs approved for pleural mesothelioma. Multiple studies prove the two drugs work best when used together, prolonging survival for patients.

Cisplatin is a platinum-based chemotherapy drug, often called by the brand name Platinol. It’s classified as an alkylating agent, which keeps the cell from reproducing by damaging the cell’s DNA.

Pemetrexed is an antifolate antineoplastic agent, which blocks cancer cells from growing and spreading to other areas of the body. The brand name for pemetrexed is Alimta.

In 2020, the FDA approved an injection form of pemetrexed for pleural mesothelioma treatment. The injection became available to patients ineligible for surgery in 2022.

According to the U.S. National Library of Medicine, the injectable form of pemetrexed is infused into a vein for approximately 10 minutes once every three weeks. This form of chemotherapy requires much less time than the standard chemotherapy treatment, which can take up to an hour.

Steps of Pleural Mesothelioma Chemotherapy

The process of receiving chemotherapy for pleural mesothelioma involves several steps, which can vary depending on the patient’s individual treatment plan. The chemotherapy success rate of administering the treatment is very high, as medical professionals have nearly perfected the process of delivering chemotherapy to patients through an IV.

The medical team will monitor the patient’s blood pressure, pulse, heart rate and temperature before, during and after the infusion to ensure the patient is not experiencing any adverse reactions. If there are any concerns or reactions noted, they may check the patient’s blood work for any changes.

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Side Effects of Pleural Mesothelioma Chemotherapy

Chemotherapy for pleural mesothelioma can have side effects. There are nearly 50 possible side effects that can range from mild to serious complications.

There are ways to minimize chemotherapy side effects, such as taking short naps regularly, avoiding fatty foods, drinking plenty of fluids, and participating in mild exercise. If patients are struggling with chemotherapy-related nausea and vomiting, doctors may recommend natural ginger or antiemetic medications.

Pleural Mesothelioma Chemotherapy Survival Rates

According to a study published in the Journal of Thoracic Disease, the median survival for pleural mesothelioma chemotherapy was reported as 12 months. Patients receiving cisplatin without pemetrexed had a median survival of nine months.

With these findings, doctors began combining the two chemotherapy drugs to improve survival.

HITHOC, the intraoperative type of chemotherapy for pleural mesothelioma, also improves survival. A study published in the Journal of Thoracic Disease demonstrated that people who received HITHOC during surgery had a median survival of 20.5 months, an increase of nearly four months compared to people who did not receive HITHOC.

Frequently Asked Questions About Pleural Mesothelioma Chemotherapy

What Type of Chemotherapy Is Used for Pleural Mesothelioma?

There are two types of chemotherapy used to treat pleural mesothelioma: systemic and HITHOC (hyperthermic intraperitoneal chemotherapy). Systemic chemotherapy, the most common approach, is where doctors administer drugs by an IV drip. Hyperthermic intraperitoneal chemotherapy is where doctors deliver heated chemotherapy drugs directly into the chest cavity.

What Chemotherapy Drugs Are Approved for Pleural Mesothelioma Treatment?

Pemetrexed and cisplatin are the two chemotherapy drugs approved by the U.S. Food and Drug Administration for pleural mesothelioma treatment. Studies prove that the two drugs can increase survival when paired together.

Can Pleural Mesothelioma Be Treated with Chemotherapy?

Pleural mesothelioma chemotherapy can increase chances of survival, reduce symptoms, and improve quality of life. Mesothelioma specialists have not yet found a cure for mesothelioma, but chemotherapy can help people with pleural mesothelioma.

Sources & Author

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About the Writer, Camryn Keeble

Camryn Keeble is a content writer and editor for Mesothelioma Guide. She creates informative content to educate mesothelioma patients and their loved ones on news, treatments and more. She also works diligently to raise awareness of the dangers of asbestos exposure and the effects of mesothelioma.