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Chemotherapy for metastatic non-small-cell lung cancer

BMJ Group Medical Reference

Introduction

This information is for people who have non-small-cell lung cancer that has spread to other parts of the body (called stage 4 or metastatic disease). It tells you about having chemotherapy. It is based on the best and most up-to-date research.

Does it work?

Yes. If you have non-small-cell lung cancer that has spread to other parts of your body (called stage 4 or metastatic disease), you are likely to live about six weeks to 10 weeks longer if you have chemotherapy. Having one of the newer chemotherapy drugs (gemcitabine, paclitaxel, or vinorelbine) by itself may help you feel more comfortable, but it may not help you live longer. You need a combination of drugs (usually a kind of drug called a platinum drug plus one of the newer drugs) to extend your life.

Chemotherapy with another newer drug called docetaxel (Taxotere) may help you live longer if you've had a platinum drug in the past and it isn't working anymore.

What is it?

Chemotherapy uses anti-cancer drugs to kill cancer cells in the lung and all over the body. There are lots of different drugs used in chemotherapy for lung cancer, and lots of different combinations of drugs. Most people have two different drugs.

You'll probably be offered chemotherapy if you have stage 3 or 4 non-small-cell lung cancer. [23] [30] [55] To learn more, see How lung cancer is treated.

For more on the stages of lung cancer, see What stage is your lung cancer?

What drugs are used?

There are lots of drugs used in chemotherapy for lung cancer. Some of the newer drugs (with their brand names) are:

  • gemcitabine (Gemzar)

  • irinotecan (Campto)

  • paclitaxel (Taxol)

  • vinorelbine (Navelbine)

  • docetaxel (Taxotere)

  • pemetrexed (Alimate).

There are also older drugs, called alkylating agents.

  • Cisplatin and carboplatin are alkylating agents. They also belong to a class of drugs called platinum drugs.

  • Other alkylating agents that are sometimes used include cyclophosphamide (brand name Endoxana) and ifosfamide (Mitoxana).

The National Institute for Health and Clinical Excellence (NICE) is the government body that decides which treatments should be available on the NHS. NICE recommends that people with advanced non-small-cell lung cancer should be offered treatment with one of these newer drugs in combination with a platinum drug. [23] [30] For example, you may be given cisplatin with gemcitabine, or cisplatin with vinorelbine. Or you may have carboplatin with paclitaxel or gemcitabine.

You might also have cisplatin with pemetrexed, but only if you have a specific type of non-small-cell lung cancer ( adenocarcinoma or large-cell carcinoma) and you haven't yet had any treatment for your cancer. [56]

There's another chemotherapy drug called bevacizumab (brand name Avastin). It can be used to treat people with non-small-cell lung cancer that isn't the squamous cell type (this is a slow-growing cancer that affects the airways). Bevacizumab is used along with platinum chemotherapy drugs. It's not officially recommended for use in the NHS, but local NHS organisations can decide for themselves whether to use it or not. [57]

Last Updated: July 05, 2012
This information does not replace medical advice.  If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.

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