Chemotherapy for Lung Cancer

This page discusses the use of chemotherapy for the treatment of lung cancer. For a thorough review of chemotherapy for cancer treatment, please see the ]]>chemotherapy treatment monograph]]> .

Cancer chemotherapy is the use of drugs to kill cancer cells. Unlike radiation and surgery, which are localized treatments, chemotherapy is a systemic treatment, meaning the drugs travel throughout the whole body. This means chemotherapy can reach cancer cells that may have spread, or metastasized, to other areas.

Chemotherapy for lung cancer is usually done in the hospital. The drugs are usually given in combination, intravenously (by IV), and in cycles. Chemotherapy may be used with other types of treatments, including radiation and surgery. It may be used to control symptoms, such as cough, pain, and shortness of breath.

Chemotherapy is a primary treatment (along with ]]>radiation therapy]]> ) for small cell lung cancer. For non-small cell lung cancer, chemotherapy is usually used to control symptoms, or in conjunction with radiation therapy or surgery to improve local control and survival.

Doctors are still working to determine the best chemotherapy regimens for lung cancer.

Chemotherapy for Non-small Cell Lung Cancer

Single Chemotherapy Agents

The following drugs have response rates greater than 15% for non-small cell lung cancer:

Cisplatin
Docetaxel (Taxotere)
Etoposide
Gemcitabine
Ifosfamide
Mitomycin C
Paclitaxel (Taxol)
Vincristine
Vinorelbine

Combination Therapies, Given by IV in Cycles

Name of Combination	Drugs in Combination
MVP	Mitomycin and vindesine Or vinblastine and cisplatin
CAP	Cyclophosphamide Doxorubicin Cisplatin
BEP	Bleomycin Etoposide Cisplatin
EP	Etoposide Cisplatin
FPV	5-Fluorouracil Cisplatin
FOMi/CAP	5-Fluorouracil Vincristine Mitomycin C Cyclophosphamide Doxorubicin Cisplatin
CE	Carboplatin Etoposide
TP	Teniposide Cisplatin
IM	Ifosfamide Mitomycin C
IE	Ifosfamide Etoposide
IP	Ifosfamide Cisplatin
MIP	Mitomycin Ifosfamide Cisplatin
ICE	Ifosfamide Carboplatin or cisplatin Etoposide
GemP	Gemcitabine Cisplatin
PacP	Paclitaxel Cisplatin
PacC	Paclitaxel Carboplatin
VrlbP	Vinorelbine Cisplatin
DocP	Docetaxel Cisplatin

Chemotherapy for Small Cell Lung Cancer

Single Chemotherapy Agents

The following drugs have response rates of at least 20% for small cell lung cancer:

Epirubicin (high-dose)
Carboplatin
Hexamethylmelamine
Ifosfamide
Teniposide

Combination Therapies, Given by IV in Cycles

Name of Combination	Drugs in Combination
EP	Etoposide (VP-16) Cisplatin
CAVE	Cyclophosphamide Doxorubicin Vincristine Etoposide (VP-16)
CAV	Cyclophosphamide Doxorubicin Vincristine
VPCP	Etoposide (VP-16) Carboplatin
ICE (VIP)	Etoposide (VP-16) Ifosfamide Cisplatin
CODE	Cisplatin Vincristine Doxorubicin Etoposide

Effectiveness

Chemotherapy offers limited curative benefit for lung cancer, but it may help in controlling symptoms. If the tumor does not respond to therapy within two or three cycles of treatment, chemotherapy is usually stopped.

Response rates for combination therapy for non-small cell lung cancer range from 10% to 60%. Adding chemotherapy to radiation for patients with Stage III non-small cell lung cancer can modestly improve outcome. It is not recommended for Stage I or II.

Response rates for combination therapy (chemotherapy plus radiation therapy) for small cell lung cancer range from 55% to 75% in patients with extensive disease and 70% to 90% in patients with limited disease.

Sources:

American Cancer Society

American Lung Association

Bast R. Cancer Medicine e5 . Hamilton, Ontario: B.C. Decker Inc.; 2000.

National Cancer Institute

Last reviewed February 2003 by ]]>Jondavid Pollock, MD, PhD]]>

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.