Lung Cancer Treatment with Chemotherapy

A number of chemotherapeutic regimens can be used to treat non-small cell lung cancer. These are usually reserved 1) for higher stages of lung cancer (stages III and IV) or 2) as adjuvant therapy, that is, to be used after surgery or 3) as neoadjuvant therapy, which is treatment before surgery. Neoadjuvant therapy is done to make the tumor smaller so that surgery will be easier or more effective. Adjuvant therapy is performed to kill cancer cells that may have been missed in the surgery or spread from the primary tumor.

The standard of care in the treatment of NSCLC is to use a platinum-based chemotherapeutic agent, especially in advanced diseases (stages III and especially IV). Most studies have shown that two agents are better than one. Three agents used in combination do not provide much additional benefit but do cause a number of additional, unpleasant side effects. Therefore chemotherapy regimens usually include two drugs. Often this combination regimen includes a platinum drug like cisplatin along with either an older (etoposide) or newer (docetaxel, gemcitabine, pemetrexed (Alimta), or vinorelbine) chemotherapeutic drug.

Chemotherapy is used to treat both limited and extensive small cell lung cancer. In limited disease, patients have been successfully treated with a single chemotherapeutic drug (when combined with radiation). In most cases though, two drugs are used rather than one. These two drugs are commonly a platinum drug and etoposide. In extensive SCLC, two chemotherapeutic drugs are used. The specific chemotherapeutic agents used in extensive SCLC vary.

The following table lists drugs approved by the Food & Drug Administration (FDA) for use in both non-small cell and small cell lung cancers. It is important to keep in mind that this list may not be all-inclusive and that new drugs are approved on a regular basis. Your best source of information on any drug or combination of drugs recommended for use in your particular case is your Medical Oncologist.