Non-Small Cell Lung Cancer - Chemotherapy Treatments

Highlights	Diagnostic Tests	Chemotherapy Treatments
Introduction	Complications	Investigative Agents
Causes	Staging Systems	Resources
Symptoms	Treatment Options by Stages	References
Risk Factors	Surgical Procedures
Lifestyle Changes	Radiation Treatments

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Chemotherapy Treatments

Chemotherapy employs drugs given orally or by injection to destroy cancer cells that may have gone beyond the tumor. Until recently there has been some doubt about the effectiveness of chemotherapy for lung cancer. A major 2002 analysis of 52 trials supported its use, particularly with platinum-based regimens and when supportive care was employed.

Chemotherapy in Early Stages. Chemotherapy is proving to be beneficial in many patients as an additional treatment with surgery or radiation.
Chemotherapy in Advanced Disease. Chemotherapy may be used as first-line therapy in patients with inoperable or metastasized lung cancer. It is typically used in late stages to reduce symptoms and, in some cases, extend survival.

Chemotherapy Drugs and Regimens

Powerful platinum compounds, either cisplatin (Platinol) or carboplatin (Paraplatin), are the basis for most chemotherapy regimens. Two-drug combinations, with one drug being a platinum-based agent, are currently the preferred regimens. Reasonable combinations include paclitaxel (Taxol) and carboplatin or cisplatin with gemcitabine, docetaxol, or vinblastine or a derivative (vindesine or vinorelbine). There does not seem to be any significant differences in effectiveness among them, however. For elderly patients who cannot tolerate platinum compounds, gemcitabine and vinorelbine combination therapy may play a role.

Chemotherapy for lung cancer may have reached its peak. Still, investigative chemotherapeutic agents may yet improve response. Many experts are pinning their hope on agents called biologic response modifiers, such as gefitinib (Iressa) or LY900003 (Affinitak). To date, however, they have not achieved better results than standard platinum-based chemotherapies and gefitinib may be withdrawn from the market due to unfavorable survival results.

Administration, Timing, and Drug Sequences

Chemotherapy treatments are usually performed in an outpatient setting and in regular cycles for several months. How many chemotherapy cycles to administer in late-stage cancers, the timing of those cycles, and the sequences of the drugs are still matters of investigation. For instance, research suggests that a three- or four-course cycle may achieve the same survival times and better quality of life than the standard of six or more course cycles. Changing even one day in a drug sequence can sometimes significantly affect outcome. Such fine-tuning of chemotherapy regimens is likely to have the most effect on patients with advanced-stage disease, which requires more tailored treatment than does early-stage disease.

Treatment for lung cancer depends on the type of cancer and the stage of the disease. Chemotherapy is a form of treatment for lung cancer which may cure, shrink or keep the cancer from spreading.