Non small cell lung cancer chemotherapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alonso Alvarado, M.D. [2]

Chemotherapeutic regimens

Shown below is a table depicting the different choices of regimens for the initial or adjuvant chemotherapy of patients with non-small cell lung cancer. The list of regimens has been adapted from the 2014 NCCN Non-Small Cell Lung Cancer guidelines.

Cisplatin based therapy

Agent	Recommended regimen
Cisplatin 50 mg/m2 + vinorelbine 25 mg/m2	Cisplatin on days 1 and 8, vinorelbine on days 1, 8, 15, 22 and every 28 days to a total of 4 cycles
Cisplatin 100 mg/m2 + vinorelbine 30 mg/m2	Cisplatin on day 1, vinorelbine on days 1, 8, 15, 22 and every 28 days to a total of 4 cycles
Cisplatin 75-80 mg/m2 + vinorelbine 25-50 mg/m2	Cisplatin on day 1, vinorelbine on days 1, 8 and every 21 days to a total of 4 cycles
Cisplatin 80 mg/m2 + vinorelbine 4 mg/m2	Cisplatin on days 1, 22, 43, 64, then every 21 days to a total of 4 cycles, vinorelbine on days 1, 8, 15, 22, 29, every 2 weeks after day 43 until the completion of cisplatin treatmet
Cisplatin 100 mg/m2 + etoposide 100 mg/m2	Cisplatin on day 1, etoposide through days 1 to 3 and every 28 days to a total of 4 cycles
Cisplatin 75 mg/m2 + gemcitabine 1250 mg/m2	Cisplatin on day 1, gemcitabine on days 1, 8 and every 21 days to a total of 4 cycles
Cisplatin 75 mg/m2 + docetaxel 75 mg/m2	Cisplatin on day 1, docetaxel on day 1 and every 21 days to a total of 4 cycles
Cisplatin 50 mg/m2 + pemetrexed 500 mg/m2	Cisplatin on day 1, pemetrexed on days 1 and every 21 days to a total of 4 cycles

Alternative regimen: patients with comorbidities or can't tolerate cisplatin

Paclitaxel 200 mg/m² on day 1 + carboplatin area under the concentration (AUC) 6 on day 1 and then every 21 days.

Chemotherapy plus radiotherapy regimens

Chemotherapy plus radiotherapy

The list bellow show the options for concomitant chemotherapy plus radiation therapy based on the 2014 NCCN Non-Small Cell Lung Cancer guidelines.

• Cisplatin 50 mg/m² on days 1, 8, 29 and 36 + etoposide 50 mg/m² through days 1 to 5 and then 29 to 33 + thoracic radiotherapy
• Cisplatin 100 mg/m² on days 1 and 29 + vinblastin 5 mg/m² weekly for 5 weeks + thoracic radiotherapy
• Cisplatin 75 mg/m² on the first day + pemetrexed 500 mg/m² on day 1 and then every 21 days to a total of 3 cycles + thoracic radiotherapy
• Carboplatin (AUC) 5 on the first day + pemetrexed 500 mg/m² on day 1 and then every 21 days to a total of 3 cycles + thoracic radiotherapy