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Targeted Therapy for Malignant Mesothelioma

As researchers learn more about the gene and protein changes in mesothelioma , they've tried to develop new drugs to target these changes. Many kinds of cancer are treated with targeted therapy today. Research is being done to see if they might work for mesothelioma, too.

Targeted therapy drugs work differently from standard chemotherapy (chemo) drugs. They sometimes work when standard chemo drugs don’t, and they often have different (and less severe) side effects.

Drugs that target blood vessel formation (VEGF)

Vascular endothelial growth factor (VEGF) is a protein that helps tumors form new blood vessels (a process known as angiogenesis) to get nutrients they need to grow. Bevacizumab (Avastin®) is a drug that stops VEGF from working. It's been found to help people with pleural mesothelioma live longer when it's given along with pemetrexed and cisplatin, when compared to giving these chemo drugs alone. 

Bevacizumab, pemetrexed, and cisplatin might be used as the main treatment for mesothelioma than can't be removed with surgery. It may then be followed by "maintenance" bevacizumab for up to a year.

Bevacizumab is given as an infusions into your vein (IV) every 2 or 3 weeks.

Possible side effects of drugs that target VEGF

Common side effects of these drugs include:

  • High blood pressure
  • Extreme tiredness (fatigue)
  • Bleeding
  • Low white blood cell counts (with increased risk of infections)
  • Headaches
  • Mouth sores
  • Loss of appetite
  • Diarrhea

Rare, but possibly serious side effects include blood clots, severe bleeding, holes forming in the colon (called perforations), heart problems, kidney problems, and slow wound healing. If a hole forms in the colon it can lead to severe infection and surgery may be needed to fix it.

Another rare, but serious side effect of these drugs is an allergic reaction during the infusion, which could cause breathing problems and low blood pressure. You'll be watched closely while getting targeted therapy.

More information about targeted therapy

To learn more about how targeted drugs are used to treat cancer, see Targeted Cancer Therapy.

To learn about some of the side effects listed here and how to manage them, see Managing Cancer-related Side Effects.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as editors and translators with extensive experience in medical writing.

Bibby AC, Tsim S, Kanellakis N, et al. Malignant pleural mesothelioma: an update on investigation, diagnosis and treatment. European Respiratory Review. 2016;25:472-486.

National Cancer Institute. Malignant Mesothelioma Treatment (PDQ®)–Patient Version. July 30, 2013. Accessed at on November 2, 2018.

National Comprehensive Cancer Network, Clinical Practice Guidelines in Oncology (NCCN Guidelines®), Malignant Pleural Mesothelioma, Version 2.2018 -- February 26, 2018. Accessed at on November 2, 2018.

Rossini M, Rizzo P, Bononi I, et al. New Perspectives on Diagnosis and Therapy of Malignant Pleural Mesothelioma. Front Oncol. 2018;8:91.

Last Revised: November 16, 2018

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