Maintenance therapy for mesothelioma is ongoing treatment with drugs that prevent recurrence or delay cancer cell growth and spreading. It may involve chemotherapy, immunotherapy or targeted therapy drugs. This therapy is administered after successful primary treatment to keep cancer growth in control.
Written by Sean Marchese, MS, RN | Edited by Walter Pacheco | Last Update: April 8, 2025
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Mesothelioma maintenance therapy is ongoing treatment with medication after the tumors have responded to the first phase of treatment.
Maintenance therapy aims to prevent recurrence or delay the growth of cancer cells following primary mesothelioma treatment. Depending on their body’s response, some patients may remain on maintenance therapy for long periods.
Ongoing research is investigating the value of maintenance therapy for mesothelioma to determine which treatments are most effective. The U.S. Food and Drug Administration has yet to approve any drugs for maintenance therapy, but mesothelioma specialists still recommend maintenance therapy to patients.
The types of maintenance therapy for mesothelioma include chemotherapy, immunotherapy and targeted therapies. These therapies are available at the nation’s top mesothelioma cancer centers.
Maintenance chemotherapy, sometimes called continuous therapy or switch-maintenance therapy, has been studied the most in mesothelioma. According to research, Alimta alone is not an effective maintenance therapy drug for mesothelioma. However, investigators continue to evaluate Alimta and the medication Gemzar for potential benefits.
I feel that surgery first, followed by chemotherapy, is the best multimodality approach for mesothelioma. [Chemotherapy] may be helpful, but it never gets rid of it. So rather than take that chance, I’d rather get it out first [using surgery].
A 2021 phase II study published in The Lancet investigated switch-maintenance chemotherapy in pleural mesothelioma patients. Half the participants switched to Gemzar and supportive care after initial treatment with Alimta and cisplatin or carboplatin. The other half received only supportive care. The Gemzar group lived three months longer, and their tumors didn’t progress as quickly as the supportive care group. They also enjoyed a better quality of life.
Maintenance immunotherapy and targeted therapy are less understood than maintenance chemotherapy for mesothelioma. However, specialists recommend these treatments to patients who meet specific eligibility criteria. For example, patients who do not respond well to chemotherapy may be considered for immunotherapy and targeted therapy drugs.
When patients decide to focus on quality of life, I bring this up to share that this is an option if they want some sort of treatment to treat the symptoms they are experiencing.
Maintenance therapy drugs control mesothelioma growth and spread in various ways. Chemotherapy drugs can directly kill mesothelioma cells to control tumor growth.
Immunotherapy drugs trigger a response that helps the immune system find and kill mesothelioma cells. Targeted therapy drugs hone in on specific molecules involved in mesothelioma growth. For example, some drugs block the development of new blood vessels, allowing tumors to grow and spread.
Patients become eligible for maintenance therapy after completing the first treatment(s) recommended by their mesothelioma doctor. Initial treatments vary among patients, from surgery to immunotherapy to chemotherapy, and the primary treatment affects follow-up maintenance therapy recommendations.
Other eligibility criteria may include specific biomarkers found in blood tests, the patient’s response to primary treatment, and their overall health.
Mesothelioma maintenance medications include chemotherapy, immunotherapy and targeted therapy drugs.
Avastin (bevacizumab) is the primary drug for targeted maintenance therapy. Physicians initially administered Avastin with cisplatin and Alimta. Some patients stay on Avastin for up to a year as maintenance therapy after completing chemotherapy. Despite the need for more research on maintenance therapy drugs, most mesothelioma specialists recommend them to patients.
Learn about the latest mesothelioma treatments and clinical trials in our updated 2025 guide.
Get Your Free GuideThe most common side effects of mesothelioma maintenance therapy are fatigue, digestive issues, fever and muscle or joint pain. Other potential side effects may include:
The side effects of maintenance therapies are generally less severe than primary treatments because patients often receive a lower dose of medication.
Coping with side effects is an essential aspect of palliative care. Palliative care is supplementary to traditional treatments and may involve prescription medications to reduce digestive issues, treat skin conditions and alleviate other side effects. Tell your doctor about any worsening side effects sooner rather than later to get help and support in your treatment journey.
Your experience with maintenance therapy for mesothelioma depends on the type of therapy your doctor recommends. The way therapy is administered, how long you need to take it, and whether maintenance therapy is combined with other treatments vary greatly.
For example, chemotherapy, immunotherapy and specific targeted therapies are provided through an IV infusion, which is given in cycles with breaks in between. Other targeted therapy drugs come in pill form. You can expect your doctor to closely monitor your health with blood tests and imaging scans while on maintenance therapy to ensure it works. Maintenance therapy can’t cure mesothelioma, but it may help keep cancer in remission longer.
You shouldn’t have to choose between getting care and paying for it. Get the financial support you deserve.
See My OptionsTo prepare for mesothelioma maintenance therapy, establish a support system. A network of family, friends and neighbors can help when you need assistance. You can rely on others for help around the house or traveling to medical appointments. Let your employer’s human resources department know about your ongoing treatment for more support and understanding at work.
In addition, those receiving chemotherapy should plan to protect household members from exposure to bodily fluids that may contain toxic chemotherapy drugs.
Maintenance chemotherapy is often less intense than initial rounds of chemotherapy because it usually involves one drug instead of two, and may involve a lower dose.
Certain maintenance therapy plans may involve painful side effects such as an infection, nausea, muscle pain and weakness.
Certain forms of maintenance therapy, such as newer immunotherapy or targeted therapy drugs, may be more expensive than maintenance chemotherapy drugs. Your health insurance provider should be able to help you understand your out-of-pocket costs.
Your doctor may decide to stop maintenance chemotherapy if you experience serious adverse side effects or if the cancer progresses significantly.
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Marchese, S. (2025, April 8). Maintenance Therapies for Mesothelioma. Asbestos.com. Retrieved December 20, 2025, from https://www.asbestos.com/treatment/maintenance-therapy/
Marchese, Sean. "Maintenance Therapies for Mesothelioma." Asbestos.com, 8 Apr 2025, https://www.asbestos.com/treatment/maintenance-therapy/.
Marchese, Sean. "Maintenance Therapies for Mesothelioma." Asbestos.com. Last modified April 8, 2025. https://www.asbestos.com/treatment/maintenance-therapy/.
Sean Marchese is a registered nurse with experience developing and managing respiratory oncology clinical trials and treatments. He has more than 10 years of clinical experience as a nurse in pain management, neurosurgery and clinical trials.
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