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NCCN Guidelines for Patients



Malignant Pleural Mesothelioma, Version 1.2016

4 Treatment guide


The length of 1 cycle of gemcitabine and cisplatin is

21 to 28 days. For each cycle, gemcitabine is given

on Days 1, 8, and 15, and cisplatin is given only on

Day 1. Vinorelbine is given 1 time every 7 days.

If the cancer grows or spreads after first-line

treatment, then you may receive second-line

treatment. However, there is little research to provide

guidelines for second-line treatment. If given as first-

line treatment, Pemetrexed should only be given as

second-line treatment if a good, lasting response was

achieved with it the first time.

Clinical trials

Clinical trials (research studies) find advances to

test for and treat mesothelioma. Because of clinical

trials, doctors find safe and helpful ways to improve

your cancer care. This guide has many of those tests

and treatments used to help people with cancer.

For example, intraoperative treatment (treatment

given during surgery) with heated chemotherapy or

photodynamic therapy (treatment with light) is being

studied for mesothelioma.

Ask your doctor if a clinical trial may be an option for

you. There may be clinical trials where you’re getting

treatment or at other treatment centers nearby. See

Part 6 for websites where you can search clinical

trials for mesothelioma.




Cancer treatment is based on the cancer stage

and cell subtype.



Chemotherapy is the use of drugs to treat




Radiation therapy uses high-energy rays to

treat cancer.



There are 2 types of surgery for mesothelioma:

P/D and EPP.



Primary treatment is the main treatment used to

rid your body of cancer.



Neoadjuvant treatment is given before surgery.



Adjuvant treatment is given after surgery.