Biphasic Mesothelioma Survival Possible in Select Patients

biphasic mesothelioma survival

A new report contains some hopeful news about biphasic mesothelioma survival. 

Biphasic mesothelioma is the rarest subtype of a rare cancer. It is also the subtype that is hardest to treat. 

Biphasic mesothelioma survival is typically shorter than other subtypes. But Italian researchers say, with the right combination of mesothelioma treatments, patients with this subtype can achieve long-term survival.

Subtypes and their Impact on Biphasic Mesothelioma Survival

All pleural mesothelioma tumors grow on the membrane that surrounds the lungs. When this membrane is healthy, it is flexible and expands naturally with each breath. 

When a mesothelioma tumor grows on this membrane, it can restrict the lungs and make it hard to breathe. As tumors grow, mesothelioma can spread to other parts of the body. 

The three mesothelioma subtypes are distinguished by subtle differences in the tumor cells. Epithelioid mesothelioma is the most common type and is most responsive to treatment. Sarcomatoid is second most common. 

Biphasic mesothelioma contains both types of cells. Biphasic mesothelioma survival depends largely on early and accurate diagnosis and aggressive treatment. 

Assessing Longevity in Biphasic Patients

For the current study, researchers examined the records of 213 patients with biphasic pleural mesothelioma. Patients received treatment at one of four hospitals between 2009 and 2016. 

The average age of the patients in the study was 68. The ratio of men to women was five to one. Almost 60 percent of the patients had Stage I mesothelioma.

The research team reviewed the clinical, pathologic, and surgical information for each patient. Then they looked for connections between the various factors and biphasic mesothelioma survival. The goal was to see what had the biggest impact on longevity.

Fifty-eight study subjects (27.2%) had pleurectomy/decortication surgery. Chemotherapy alone was the treatment choice for 99 patients (46.5%). Fifty-six patients only had best supportive care.

Improving BIphasic Mesothelioma Survival

The median overall survival of patients in the study was 11 months. The factors that had the biggest impact on long-term biphasic mesothelioma survival were:

  • How much air a patient could exhale in one second
  • Overall health (performance status)
  • Cancer stage
  • Multimodal treatment that included surgery

Not all biphasic mesothelioma patients are eligible for surgery. But the new study suggests that biphasic mesothelioma survival may hinge on correct identification of the patients who are. 

“Despite the overall poor prognosis of biphasic histology, a multimodal approach, including cancer-directed surgery, is associated with improved long-term results in very selected patients with biphasic malignant pleural mesothelioma,” concludes the report. 


Lococo, F, et al, “Survival results in biphasic malignant pleural mesothelioma patients: A multicentric analysis”, September 9, 2019, Journal of Thoracic and Cardiovascular Surgery, Epub ahead of print,

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