Non-Small Cell Lung Cancer - Radiation Treatments

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Erlotinib (Tarceva) is in the same medication class as gefitinib. It is approved for patients with locally advanced or metastatic non-small cell lung cancer who have failed one type of chemotherapy treatment in the past (it is a second-line treatment). Unlike gefitinib, erlotinib shows survival and progression-free benefits compared to placebo. However, it should not be combined with platinum-based chemotherapy.

Pemetrexed (Alimta). Pemetrexed, known as an anti-folate, is a new drug for first-line treatment of advanced nonsquamous non-small cell lung cancer, in combination with cisplatin. The drug targets a number of enzymes that play a role in how cancer cells increase. Pemetrexed does have some serious toxic effects, but they can be significantly reduced with folic acid and vitamin B12 supplements.

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Administration, Timing, and Drug Sequences

Chemotherapy treatments are usually performed in an outpatient setting. They are given in regular cycles for several months. Researchers are still investigating how many chemotherapy cycles to administer in late-stage cancers, the timing of those cycles, and the sequences of the drugs. For instance, 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. However, changing even one day in a drug sequence can sometimes significantly affect the 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 early-stage disease.

Side Effects

Side effects of chemotherapy treatments are common, and they are more severe with higher doses. Side effects increase over the course of treatment. Some studies suggest that side effects can be reduced by giving the drugs for shorter durations, without losing the cancer-killing effects.

Common side effects include the following: