Chemotherapy
Systemic Therapy
Several types of systemic drug modalities can be used to treat lung cancer. These include traditional chemotherapy, immunotherapy, and targeted therapy. These different types of systemic treatments can be used alone or in combination to treat lung cancer that is locally advanced (Stage III) or metastatic (Stage IV). Goals of systemic therapy include cure or palliation of symptoms. In the curative setting, treatment may be given before surgery (neoadjuvant) or after surgery (adjuvant) for a set duration of time. In the palliative setting, treatment is given indefinitely, as long as the patient is tolerating therapy and the disease is not progressing.
Chemotherapy
Chemotherapy is a type of cytotoxic treatment, meaning it directly kills cancer cells by inhibiting their ability to divide (also known as cell proliferation). Chemotherapy for lung cancer typically consists of 1 to 2 drugs administered intravenously. Sometimes chemotherapy may be given in combination with radiation therapy. Chemotherapy can be administered through a peripheral vein (typically a vein in the arm) or through a port. A port is a small reservoir that is implanted under the skin and attached to a central vein (a vein near the heart). Some chemotherapy may require administration through a port to reduce irritation to the vein that may occur during infusions.
Common chemotherapy agents used in lung cancer:
- Cisplatin (Platinol®)
- Carboplatin (Paraplatin®)
- Pemetrexed (Alimta®)
- Paclitaxel (Taxol®)
- Nab-paclitaxel (Abraxane®)
- Docetaxel (Taxotere®)
- Gemcitabine (Gemzar®)
- Etoposide (VP-16)
- Vinorelbine (Navelbine®)
- Irinotecan (Camptosar®)
- Topotecan (Hycamptin®)
- Lurbinectedin (Zepzelca®)
Chemotherapy is typically given on a schedule known as a “cycle.” A cycle is usually 21 to 28 days in length. Most lung cancer drugs are given 1 to 3 times during a cycle.
Common side effects associated with lung cancer chemotherapy are:
- Fatigue
- Nausea and/or vomiting
- Mouth sores
- Bowel changes (constipation or diarrhea)
- Hair loss
- Nail changes
- Appetite and/or taste changes
- Infection (due to low white blood cells)
- Bleeding (due to low platelets)
- Anemia (due to low hemaglobin)
- Neuropathy