Chemotherapy & Targeted Drugs for Non-Small Cell Lung Cancer

Doctors may recommend chemotherapy alone or in combination with radiation therapy, to help shrink a non-small cell lung tumor before surgery. These treatments may also be given after surgery to help destroy any remaining cancer cells.

Chemotherapy and radiation may be also used instead of surgery to treat earlier stage lung cancers.

The chemotherapy drugs used for non-small cell lung cancer are usually given through a vein as an intravenous (IV) infusion. Some of the more commonly used medications include cisplatin, carboplatin, pemetrexed, paclitaxel, docetaxel, gemcitabine, and vinorelbine. Doctors typically use a combination of two chemotherapy drugs to manage non-small cell lung cancer while minimizing side effects.

Chemotherapy is usually given a for one to three days, for several hours each time, every one to three weeks, which gives the body time to rest and recover. This treatment cycle may be repeated several times.

Targeted drugs are designed to target proteins in cancer cells that may help cancer cells grow.

They include epidermal growth factor receptor (EGFR) inhibitors, anaplastic lymphoma kinase (ALK) inhibitors, BRAF inhibitors, ROS1 inhibitors, MET inhibitors, RET inhibitors, and HER2 inhibitors. Our researchers study newer targets in clinical trials.

Vascular Endothelial Growth Factor Inhibitors

Vascular endothelial growth factors (VEGF) are proteins that promote blood vessel growth. Tumors feed from these proteins to grow. VEGF-receptor inhibitors are medications that can block new blood vessel growth. They are sometimes used in combination with chemotherapy drugs.

Immunotherapy

Immunotherapy targets the immune cells, rather than cancer cells, to help boost the body’s immune response against cancer. PD-1 or PD-L1 inhibitors, such as pembrolizumab, nivolumab, and atezolizumab, can block immune suppression, reactivating immune cells to attack cancer.

Our pathologists test biopsy tissue for the presence of PD-L1 to determine if immunotherapy should be prescribed. Sometimes, PD-1 inhibitors are used instead of chemotherapy, while other times they may be used after or in combination with chemotherapy. For a small group of people with non-small cell lung cancer, PD-1 or PD-L1 inhibitors can lead to much longer-lasting cancer control.

Our clinical trials evaluate new immunotherapies and new combinations of therapies using PD-1 inhibitors.

Our doctors work closely with supportive care specialists to help manage side effects related to cancer and cancer therapy, including physical and psychological effects.

Common side effects of chemotherapy and other lung cancer therapies can include nausea, vomiting, diarrhea, and fatigue, which our doctors can often manage by adjusting the dosages, giving additional medications, or referring you to supportive and integrative health therapies.

Some targeted therapies can cause skin side effects. Our oncologists work closely with NYU Langone dermatologists to help manage these symptoms. Immunotherapy can have unique inflammatory side effects and oncologists at Perlmutter Cancer Center, along with specialists at NYU Langone, can help you manage these side effects.

Neuropathy, which affects sensation and strength in the arms, legs, hands, feet, and elsewhere in the body, can be a later side effect of some types of chemotherapy. The condition is also associated with discomfort, as well as weakness and difficulty balancing and walking. Our doctors at NYU Langone’s Rusk Rehabilitation can help manage these symptoms and coordinate rehabilitation programs to improve your strength, balance, walking, and physical function.

Researchers at NYU Langone’s Perlmutter Cancer Center are studying new therapies for the treatment of early and advanced lung cancer. This includes studying cancers that have identified molecular “drivers,” small cell lung cancers, and cancers which may be likely to respond to immunotherapy. We are also studying combinations of immunotherapies and targeted drugs, including before and after surgery or radiation.

Our oncologists work with our interventional pulmonologists to develop clinical trials to study targeting therapies directly into lung cancer tumors and combining these approaches with systemic therapies. Our interventional pulmonologists are also studying novel techniques to treat tumors using bronchoscopy.