Standard Chemotherapy With of Without Axitinib in Malignant Mesothelioma

Inclusion Criteria:

* histologically or cytologically diagnosed malignant mesothelioma
* age \> 18 years
* Medically suitable for limited surgical intervention (pleural biopsies or limited pleurectomy)
* Measurable or evaluable disease is not required
* Ability to understand the study and give signed informed consent including the approval to accept a second thoracoscopic or surgical treatment after the third course
* No previous chemotherapy
* Radiotherapy is allowed when this is given for palliation, the interval is \> 4 weeks, not more than 1/3 of the bone marrow capacity or all tumor is within the irradiation field.
* WHO performance status =\< 2
* Adequate organ function as evidenced by the following peripheral blood counts or serum chemistries at study entry:

Hematology:

* ANC=\>1.5 x 109/L,
* Platelets=\>150 x 109/L,
* Hemoglobin =\> 6,0 mmol/l

Chemistry:

* total serum bilirubin \< UNL;
* AST and ALT= \< 2.5xUNL,
* AP \< 5xUNL (unless bone metastases are present in the absence or any liver disease)
* Serum creatinine =\< 2xUNL

Exclusion Criteria:

* Active uncontrolled infection, severe cardiac dysfunction or uncorrectable bleeding tendency
* Previous successful pleurodesis
* Uncontrolled hypertension
* Symptomatic peripheral neuropathy =\> grade 2 according to NCIC CTC,version 3.0
* Presence of symptomatic CNS metastases
* Unstable peptic ulcer, unstable diabetes mellitus or other serious disabling condition
* Concomitant administration to any other experimental drugs under investigation
* Impaired renal function