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Chemotherapy for Non-Small Cell Lung Cancer

Even tumors that are completely removed by surgery or destroyed by radiation therapy can return if microscopic cancer cells have traveled from the primary tumor to other parts of the body. Chemotherapy is a drug or combination of drugs that travels throughout the body to kill cancer cells wherever they might be.  Medical Oncologists give chemotherapy to many patients with non-small cell lung cancer, either before or after surgery.

Which drugs you receive depends on what kind of non-small cell lung cancer you have — adenocarcinoma, squamous cell carcinoma, or large cell lung cancer and may also depend on the results from the genetic testing of your tumor, which may indicate that one chemotherapy regimen will work better than another.

Our physicians work closely with each other as a team to determine when, and whether, to give chemotherapy.

Chemotherapy before Surgery (Neoadjuvant Chemotherapy)

The first place where cancer cells spread from a primary tumor in the lungs is often to the lymph nodes (also called lymph glands). This is because the lymph nodes act as a filter, trapping cancer cells as they travel out of the lungs.

In some circumstances, giving chemotherapy before surgery can improve cure rates in patients with non-small cell lung cancer that has spread to lymph nodes. This technique, called neoadjuvant chemotherapy, involves giving the patient several months of chemotherapy prior to surgery. In some cases, cancer cells in the lymph nodes can be completely eliminated before surgery.

This approach has doubled the cure rate in patients with stage III non-small cell lung cancer, and has cured patients with some forms of lung cancer who would not have been cured by surgery alone.

Chemotherapy after Surgery (Adjuvant Chemotherapy)

Another approach is to give chemotherapy after surgery; this is called adjuvant chemotherapy. Whether your doctor recommends adjuvant chemotherapy depends on a variety of factors, including the size of the tumor. Adjuvant chemotherapy is often prescribed when the cancer cells have spread to lymph nodes. Traditional adjuvant chemotherapy can help you to live longer and improves your chance for a cure.

Clinical Trials of New Chemotherapy Drugs

For many patients, the best strategy may be to enroll in a clinical trial that tests new drugs. These drugs can be tested either alone or in combination with more established treatments.

Treatment of lung cancer has become increasingly tailored to the histology (appearance under the microscope) and molecular profile of each patient’s tumor. 

Many of our current clinical trials are designed around the mutational testing that we perform on almost all non-small cell lung cancer patients. Our goal is to individualize the treatment to be as specific and as targeted as possible.