Chemotherapy for mesothelioma has new rival systemic therapy: immunotherapy.

However, the long-used method for treatment remains effective for some patients.

Doctors tested two stages – and types – of chemotherapy for surgical cases of pleural mesothelioma. The patients all had the epithelioid cell type, which offers the best survival expectancy.

The surgeons and oncologists used “induction chemotherapy” – also called neoadjuvant chemotherapy, or chemo before surgery – followed by pleurectomy with decortication surgery. During this operation, the medical team administered “HITHOC”, which stands for hyperthermic intrathoracic chemotherapy.

HITHOC is a form of intraoperative chemotherapy, or chemotherapy given during surgery. Doctors place ports near the chest to funnel heated chemotherapy drugs into the body. The drugs essentially burn any small cancer cells not removed during pleurectomy/decortication.

Since this surgery leaves both lungs, some tiny cells may persist in crevices of the chest cavity. HITHOC is an effective tool to address these cells without damaging lung tissue, as is the concern with postoperative radiation therapy.


Results of Study Using Systemic Chemotherapy and HITHOC

There were 65 patients in the study, but only 12 progressed to surgery after induction chemotherapy. The overall survival was 31 months, while the one-year survival rate was 100%.

There was more impressive data from the study:

  • 55% three-year overall survival rate
  • Progression-free survival of 26 months
  • 92% one-year progression-free survival rate
  • Disease-free survival of 19 months


What This Means for Mesothelioma Patients

This news means people with the cancer diagnosis of mesothelioma have options to improve their outlook. Mesothelioma is treatable – in plenty of ways.

Patients often start with chemotherapy when they can’t have surgery. Even if they can have surgery – or it’s an unknown – opening with chemotherapy is a good barometer for how they’ll do with surgery. If they can have surgery, then maybe they can have intraoperative chemotherapy.

The most important part of treatment is going to a mesothelioma cancer center. These medical institutions have specialists – oncologists, surgeons and other staff – to provide the best opinions and medical care specifically for mesothelioma. They also have much better survival rates than local hospitals without much experience treating this type of rare cancer.

We can help you or your loved one find a cancer center nearby. Karen Ritter, our registered nurse and patient advocate, has helped answer many patients’ questions and find them options. Her email is

    Sources & Author

    • Induction Chemotherapy Followed by Pleurectomy Decortication and Hyperthermic Intraoperative Chemotherapy (HITHOC) for Early-Stage Epithelioid Malignant Pleural Mesothelioma-A Prospective Report. Journal of Clinical Medicine. Retrieved from: Accessed: 12/17/2021.
Devin Goldan image

About the Writer, Devin Golden

Devin Golden is the content writer for Mesothelioma Guide. He produces mesothelioma-related content on various mediums, including the Mesothelioma Guide website and social media channels. Devin's objective is to translate complex information regarding mesothelioma into informative, easily absorbable content to help patients and their loved ones.

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