Multimodal therapy for mesothelioma is a treatment approach that uses more than one drug or cancer therapy. The standard therapies for mesothelioma include surgery, chemotherapy, and radiation therapy. Better outcomes are usually achieved when a patient tries a combination of chemotherapy drugs and another indicated treatment, such as surgery, radiation, or an experimental treatment.
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Surgery to remove the primary tumor is performed if an individual can tolerate and benefit from surgery. The affected lung and surrounding structures may be removed or spared. Chemotherapy and radiation may be given before or after surgery or at both times to target any other cancer cells and prevent tumor recurrence. Radiation therapy performed after surgery may be more effective when delivered at modulated intensities. Finally, experimental treatment may or may not be pursued, depending on the individual’s goals of care.
Additional factors that determine which treatments are pursued include mesothelioma stage and grade, cancer recurrence, and an individual’s overall health status. There is no one multimodal therapy strategy that fits all. Input from an oncology team composed of medical, surgical, and radiation oncologists is instrumental in guiding this approach.
Experimental Treatments
Experimental treatments may be included in multimodal therapy. Some of the most promising experimental treatments for mesothelioma include:
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Immunotherapya treatment that stimulates the immune system to target and kill cancer cells without killing healthy cells
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Tumor treating fields
a treatment that uses specific electrical frequencies to prevent cancer spread and kill cancer cells
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Photodynamic therapy
a treatment that uses light energy in conjunction with a photosensitizing drug to kill cancer cells
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Gene therapy and personalized medicine
an approach that tailors an individual's treatment to their unique genetic variation
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Graded treatment
a strategy of choosing a treatment based on its effectiveness in treating other cancers with similar microscopic features
Success Rates
Generally, when multiple therapies are combined to treat mesothelioma, better outcomes are achieved. The caveat is that the individual must be healthy enough to withstand the side effects of multiple cancer therapies. Similarly, if an individual wishes to pursue an experimental therapy as part of their treatment strategy, they must be healthy enough to meet a clinical trial’s unique eligibility criteria to receive the therapy.
As no one multimodal therapy can best fit all individuals, no one strategy has proven superior to another. Further research is needed to develop more tolerable multimodal therapies and to determine which treatment combinations are effective in which individuals.