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 (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
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.