Systemic treatment for unresectable pleural mesothelioma
Systemic treatment for unresectable pleural mesothelioma
Treatment approaches for patients with pleural mesothelioma are evolving, and patients are encouraged to participate in clinical trials, when possible.
* Contributors are divided in regards to whether or not they offer maintenance therapy after pemetrexed plus platinum. While some offer pemetrexed or bevacizumab maintenance to those without contraindications, others do not offer maintenance therapy. In the setting of limited data suggesting modest benefit, a choice regarding maintenance therapy should be made based on individual patient comorbidities and preferences. ¶ Immunotherapy with nivolumab plus ipilimumab is an appropriate alternative in this setting, particularly for those who are not candidates for the doublet of pemetrexed plus platinum. Δ Immunotherapy options include the combination of nivolumab plus ipilimumab, or for those who are less likely to tolerate this combination, single-agent pembrolizumab or nivolumab. Single-agent chemotherapy options include gemcitabine, vinca alkaloids, or anthracyclines.
