Medical Health Encyclopedia

These side effects are nearly always temporary. Most patients are able to continue with normal activities for all but perhaps one or two days per month.

Serious complications can also occur and may vary depending on the specific agents used. They include the following:

• Increased chance for infection from suppression of the immune system.
• Severe drops in white blood cells (neutropenia). Certain agents, such as taxanes, pose a higher risk for this than other chemotherapeutic drugs. White blood cell count may be improved with the addition of a type of drug called granulocyte colony-stimulating factor (either filgrastim and lenograstim).
• Liver and kidney damage. Amifostine (Ethyol) reduces the risk for kidney damage in patients taking repeated regimens of cisplatin-based therapy. It is also a radioprotector; that is, it helps prevent severe effects in the esophagus from radiotherapy with or without chemotherapy.
• Abnormal blood clotting (thrombocytopenia).
• Allergic reaction, particularly to platinum-based agents. (A simple skin test is under investigation that may identify people with a potential allergic response.)

Second-Line Chemotherapy

Second-line chemotherapy is used for patients whose cancers have recurred after first-line chemotherapy. Some experts believe that longer survival rates for advanced lung cancer being observed for the past five years may be due to these agents. Because platinum-based agents are most often used initially in most cases, they are not beneficial for second-line therapy. The following are commonly used second-line agents.

Text Continues Below

---

Docetaxel (Taxotere). Docetaxel (Taxotere) is the drug of choice at this time for cancers that do not respond to initial chemotherapy. Studies have reported that it achieves longer survival times than supportive care alone. It is usually given every 21 days. This regimen causes higher toxicity than pemetrexed, the newer major second-line drug. Weekly doses of docetaxel are effective and less toxic than the three-week schedule. It is not clear if survival rates are comparable to those of pemetrexed with that schedule, however.