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mesothelioma chemotherapy

How Does a Doctor Choose Which Chemotherapy Drugs to Administer?

  • Research: Chemotherapy was introduced for the first time in the 1940’s. For the next two decades, it was mainly used as an investigational treatment procedure. However, a lot more information about chemotherapy has been gathered in the last 3 decades and a variety of effective drugs are now available. Over the years, doctors have documented responses and carried out clinical trials in order to compare conventional treatment procedures with new ones.

    Information gathered on chemotherapy has helped establish specific treatment protocols (class of drugs, dosage and usage schedule) depending on the type and stage of the cancer and other details about the patient’s tumor. Currently, standard protocols have been established for most forms of cancer, allowing doctors to choose the right chemotherapy for cancer patients.

  • Response rates: During the process of evaluating chemotherapy information and selecting a protocol for a particular patient, doctors will take into account the response rates of chemotherapy drugs and their documented effectiveness in various stages of cancer. Response rates are expressed in percentage terms and they indicate the total number of patients whose tumor will react (shrink or disappear) to the administered drug/drugs. Response rates are ascertained through research. For instance, a particular form and stage of cancer may have a response rate of 70% in relation to a specific drug or combination of drugs. This implies that 70% of patients with this form and stage of tumor will respond (the tumor shrinks or disappears) to this drug or drug combination. However, it also implies that 30% of the patients with similar condition will show no response or will only display minimal response. Responses to chemotherapy treatment can be either complete or limited (these assumptions are based on the form of cancer and the related protocol). Response duration is another factor that influences drug selection. It is a measure of the effective response duration of the administered drug/drugs. For every drug protocol, an average response duration has been documented through research. Doctors select protocols that have the highest response rates and longest documented durations.

  • The patient’s health: Chemotherapy drugs have toxicities. They should be administered with care even when the individual may be of sound health. Tolerating certain chemotherapy protocols may not be possible for individuals who are very old and weak or those who have medical complications. In such cases, the treatment benefits should be compared with potential risks prior to choosing the treatment procedure. In certain cases, doctors may prescribe a single drug instead of a standard drug combination. In other cases, the patient and the doctor may choose to forego chemotherapy and, instead, focus efforts on improving quality of life.

When selecting a chemotherapy treatment, there is no single, correct choice. All treatment protocols have their own distinct benefits and drawbacks, and there can be more than one effective option. Moreover, treatment options may change with time. A chemotherapy treatment considered good at a particular time may not remain the preferred choice at a later time.

Even though doctors make use of the most recent chemotherapy research and choose combination protocols with the highest expected response rates, it is still difficult to guarantee the desired response. For any patient, predicting the outcome of a chemotherapy treatment is impossible. However, there has been a dramatic improvement in response rates and since new drugs are regularly being developed, the outcomes will keep on improving.


This website is sponsored by Brad Cooper* of The Cooper, Hart, Leggiero, & Whitehead, PLLC. Cooper, Hart, Leggiero, & Whitehead is located in The Woodlands, Texas (Greater Houston Area) and can be reached toll free at 1-800-998-9729 for more information on mesothelioma. Brad Cooper is not a medical doctor. The information on these pages is for the education of mesothelioma patients and their families regarding potential medical and legal options. Patients are advised to consult with a medical doctor.

*  Licensed by the Supreme Court  of Texas.




The use of chemotherapy in patients with advanced malignant pleural mesothelioma: a clinical practice guideline.

Advances in the systemic therapy of malignant pleural mesothelioma

Kinase Inhibitors for Mesothelioma Treatment

journal abstracts

Active symptom control with or without chemotherapy in the treatment of patients with malignant pleural mesothelioma (MS01): a multicentre randomised trial

The second wave in kinase cancer drugs

Cisplatin and vinorelbine first-line chemotherapy in non-resectable malignant pleural mesothelioma

Cytoreductive surgery and intraperitoneal chemotherapy for peritoneal mesothelioma.