Treatments

Treatments we offer

At UCLA Health, we use treatment approaches that have been pioneered by our experts and that are tailored for each individual patient. This personalized approach is designed to give people the best chance for a positive outcome. Our mesothelioma care plans involve a series of consecutive treatments that often include:

Chemotherapy

The most common chemotherapy drugs for mesothelioma are pemetrexed and cisplatin. These medications are often given together to improve effectiveness. Chemotherapy may help shrink tumors, relieve symptoms, and slow the spread of cancer.

Chemo-biotherapy

Some patients may receive chemotherapy in combination with bevacizumab, a biologic therapy that blocks the growth of blood vessels feeding the tumor. This combination has been FDA-approved since 2004 and may be especially effective in treating epithelioid mesothelioma, the most common subtype. Bevacizumab is not appropriate for everyone, but it can be a powerful addition for certain patients.

Immunotherapy

Mesothelioma is a type of cancer that can be difficult to remove completely, even with surgery and radiation therapy. Immunotherapy helps the immune system find and destroy any remaining cancer cells.

A common treatment includes ipilimumab and nivolumab, two medications that boost the body's natural defenses against cancer. This approach has been especially effective for certain types of mesothelioma. At UCLA Health, our experts pioneered maintenance interferon-alpha therapy, a specialized immunotherapy that keeps the immune system active against mesothelioma. By using the lowest effective dose, we help patients stay on immunotherapy as long as possible while maintaining their quality of life.

Chemoimmunotherapy

This is a combination of chemotherapy and immunotherapy for mesothelioma.

Cryoablation

UCLA Health is proud to have pioneered the use of cryoablation for patients with mesothelioma. Cryoablation is a breakthrough freezing technique used to destroy cancerous nodules. In some people, individual nodules (growths) may develop in the chest cavity after treatment. During a straightforward outpatient needle procedure, our interventional radiologists often use cryoablation to precisely target and eliminate these nodules.

Cryotherapy is a procedure in which a probe is inserted into a small mesothelioma tumor in the chest wall or lung for killing of its tumor cells by cold temperature.

Radiation therapy

UCLA Health offers highly specialized whole pleura targeted radiation using tomotherapy machines. This advanced technique, most often delivered once a patient recovers from surgery, allows us to deliver radiation specifically to the area that was affected by the tumor while minimizing harm to normal tissues such as the lung. 

Tomotherapy is a specialized form of radiation therapy that can be delivered more precisely than more typical forms of radiation therapy and that may be recommended following Pleurectomy/Decortication surgery.

Surgery

Pleurectomy and decortication is our frontline surgical treatment for mesothelioma. During this procedure, our thoracic surgeons remove the lining of the chest cavity (pleura) where the tumor is located, without removing the lung. This is a major operation that has a goal to have no visible tumor within the chest. 

(A) Pleurectomy/Decortication is an operation in which the mesothelioma tumor is resected from the chest wall, and also from the surface of the lung, pericardium (sac over the heart), and diaphragm. (B) When the operation requires resection and reconstruction of the pericardium and diaphragm, this is called an Extended Pleurectomy/Decortication.

Extrapleural pneumonectomy Extrapleural pneumonectomy is an operation performed in rare circumstances to remove pleural mesothelioma tumors that involves removal of the lung in addition to the pericardium and the diaphragm, with reconstruction of the lung and the diaphragm. 

An extrapleural pneumonectomy operation is one in which mesothelioma tumor resection requires resection of the lung and resection and reconstruction of the pericardium and diaphragm.

A thoracotomy is an incision on the side and back of the chest during which the surgeon enters the chest through a space between the ribs.

Pleural mesothelioma tumors that are considered for surgery are generally considered to be tumors that are confined to one side of the chest.

Mesothelioma tumors that may generally considered for resection include those that are isolated to one side of the chest. If the tumor involves the diaphragm, pericardium, lymph nodes, or a small area of the chest wall on the same side as the tumor, these tumors may still be recommended for resection.

Pleural mesothelioma tumors that are typically not considered for surgery are those that have spread to the other side of the chest, to the abdominal cavity, to other organs, or that involve large segments of the chest wall. 

Mesothelioma tumors that are generally not considered are those that include metastases on the other side of the chest from the main tumor, that have spread to the abdomen (peritoneal metastases), or within an organ such as the liver.

Tumor treating fields (TTF)

The Optune Lua device uses electrical fields to prevent tumor cells from dividing and growing. TTF is delivered through ceramic discs arrays that we apply to the outside of your chest to disrupt tumor growth. This treatment is most effective when used alongside with chemotherapy.

Clinical trials

UCLA Health conducts clinical trials that offer promising new treatments for mesothelioma—sometimes years before they’re widely available. Our doctors are testing the latest therapies, including new types of immunotherapy and targeted drugs. See if a clinical trial is right for you.