More than 200,000 new cases of lung cancer are typically diagnosed in the United States every year, according to the National Cancer Institute. Lung cancer starts in the lung tissues. There are two main types: non-small cell lung cancer, and small cell lung cancer. Treatment is very different for each type, but chemotherapy is a treatment modality used in both types.
Small Cell Lung Cancer
Small cell lung cancer (SCLC) makes up about 10 to 15 percent of all lung cancer cases, according to the American Cancer Society. The name comes from the small cells that comprise this cancer. Other names for it are oat cell carcinoma and small cell undifferentiated carcinoma. This type is also usually caused by smoking.
Chemotherapy is generally the main treatment for SCLC, and typically comprises a combination of two drugs. Different combinations include: cisplatin and etoposide; carboplatin and etoposide; cisplatin and irinotecan; carboplatin and irinotecan; and cyclophosphamide, doxorubicin and vincristine.
If the cancer comes back after treatment, different drug combinations are often used.
Non-Small Cell Lung Cancer
The remaining 85 to 90 percent of lung cancers are known as non-small cell lung cancers (NSCLC). There are three subtypes of NSCLC: adenocarcinoma, squamous cell carcinoma, and large cell carcinoma. These cells all look very different from each other when examined microscopically. Treatment for NSCLC typically include some combination of surgery, radiation and chemotherapy, depending on the stage and type of cancer.
Chemotherapy for NSCLC consists of two drugs; adding a third does not appear to improve the effectiveness of the drug, and adds to adverse side effects, according to the American Cancer Society. Drugs that are most often used for initial treatment for NSCLC include: cisplatin, carboplatin, paclitaxel, docetaxel, gemcitabine, vinorelbine, irinotecan, etoposide, vinblastine and pemetrexed. Common regimens include either carboplatin or cisplatin.
If the cancer returns, second-line drug treatment is usually one drug, typically docetaxel or pemetrexed. Targeted drug therapies might also be an option.
Targeted Therapies
In addition to the traditional drug regimens for lung cancer, newer chemotherapeutic drugs have been discovered, called targeted therapies. These drugs target the cancer, without damaging other cells, thus lessening side effects. There are several drugs that target different growth factors of the cancer. These include bevacizumab (brand name Avastin), erlotinib (brand name Tarceva) and cetuximab (brand name Erbitux). Sometimes these drugs are added to a standard chemotherapy regimen for lung cancer, and they can also be used when the cancer no longer responds to the current chemotherapy.
