Priority 4 from the Mesothelioma PSP

In mesothelioma patients, what is the best second line treatment (i.e. what chemotherapy drugs should be used if a cancer has recurred following first line chemotherapy, usually with cisplatin and pemetrexed)? (JLA PSP Priority 4)
Overall ranking 4
JLA question ID 0025/4
Explanatory note Not available for this PSP
Evidence No systematic reviews identified.  Ongoing study - VIM - Vinorelbine in Mesothelioma
Health Research Classification System category Cancer
Extra information provided by this PSP
Original uncertainty examples After several courses of chemo with Carbo and Alimta I developed an allergic reaction to Alimta.  What are my chemo options now? ~ Two months after this treatment the fluid was back and had his chest drained again. Why was he not offered further chemo? ~ role of second line chemotherapy includingg rechallenge with pemetrexed based chemotherapy ~ Dad was advised that he wouldn't be given any more chemo as it wouldn't work. On what basis is this deduced? Is this a funding issue?
Comparison Drug
Submitted by Patient ~ Bereaved ~ Health Professional ~ Carer
Outcomes to be measured Response and survival
PSP information
PSP unique ID 0025
PSP name Mesothelioma
Total number of uncertainties identified by this PSP. 53  (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 16 December 2014