Chemotherapy

Reviewed by: HU Medical Review Board | Last reviewed: November 2023

Chemotherapy, or chemo, is a type of cancer treatment that uses certain drugs to kill cancer cells. Chemotherapy drugs travel through the bloodstream (also known as systemic treatment). This means chemo drugs can reach most parts of the body to kill cancer cells anywhere. Many people with lung cancer receive chemotherapy treatment.1,2

Doctors may suggest chemotherapy before, during, or after other treatments. These treatments may include surgery, radiation therapy, immunotherapy, or targeted therapy. Your doctor will talk to you about which treatment plan is right for you.1,2

How does chemotherapy work?

Chemotherapy drugs work by blocking cell growth and division. This kills cells that divide quickly, like cancer cells. Chemotherapy drugs damage cancer cells, but they can damage healthy cells as well.3

Chemotherapy drugs are also called anti-neoplastic drugs. This means they help prevent the development, growth, or spread of neoplasms (tumors).3

When is chemotherapy used?

Whether you need chemotherapy depends on your cancer type and stage, along with other factors. For example, not all people with non-small cell lung cancer (NSCLC) need chemotherapy. But your doctor may recommend it in certain situations, including:1

  • Before surgery to reduce the size of a tumor and make it easier to remove
  • After surgery to kill any remaining cancer cells in the body
  • With radiation therapy when surgery is not an option
  • As the main treatment if lung cancer has spread to areas outside the lung

Most people with small cell lung cancer (SCLC) receive chemotherapy treatment. This is because the cancer has usually spread outside the lung when diagnosed. Surgery or radiation therapy alone will not reach where it has spread. Treatment for SCLC may combine chemotherapy with radiation therapy or immunotherapy.2

Examples of chemotherapy for lung cancer

Chemotherapy drugs for lung cancer work in different ways to kill cancer cells. Many people with lung cancer take multiple drugs that work in different ways. The right type for you depends on many factors.3-5

Alkylating agents

Alkylating agents work by damaging DNA, the material that makes up your genes. This keeps cells from growing and dividing. Alkylating agents used to treat lung cancer include:3-5

  • Paraplatin® (carboplatin)
  • Platinol® (cisplatin)
  • Zepzelca™ (lurbinectedin)

Antimetabolites

Antimetabolites look similar to the building blocks of DNA and RNA. These drugs keep DNA from being copied, which prevents cells from reproducing. Antimetabolites used to treat lung cancer include:3-5

  • Alimta® (pemetrexed)
  • Gemzar® (gemcitabine)

Mitotic inhibitors

Mitotic inhibitors are drugs that block cell division (mitosis). Mitotic inhibitors used to treat lung cancer include:3-5

  • Navelbine® (vinorelbine)
  • Taxol® (paclitaxel)
  • Taxotere® (docetaxel)
  • Velban® (vinblastine)

Topoisomerase inhibitors

Topoisomerase inhibitors block enzymes called topoisomerases. These enzymes separate DNA strands so they can be copied. Blocking them prevents cell division and growth. Topoisomerase inhibitors used to treat lung cancer include:3-5

  • Camptosar® (irinotecan)
  • Hycamtin® (topotecan)
  • VePesid®, Toposar® (etoposide)

Anti-tumor antibiotics

Anti-tumor antibiotics are not the same as antibiotics that treat infections. Some anti-tumor antibiotics are anthracyclines. This means they interfere with the structure of DNA. This keeps cells from reproducing and dividing. One anti-tumor antibiotic used to treat lung cancer is Adriamycin® (doxorubicin).3-5

What are the possible side effects?

Chemotherapy drugs can kill healthy cells that divide quickly as well as cancer cells. Healthy cells may include cells throughout the body, such as in the bone marrow, intestines, and hair follicles. This can lead to side effects.1,2

Side effects can vary depending on the specific drug you are taking. Common side effects of certain chemotherapy drugs include:1,2

  • Hair loss
  • Mouth sores
  • Loss of appetite or weight changes
  • Nausea and vomiting
  • Diarrhea or constipation
  • Increased risk of infections (due to low white blood cell counts)
  • Easy bruising or bleeding (due to low blood platelet counts)
  • Fatigue (due to low red blood cell counts)

Side effects typically stop after treatment is completed. Some drugs can lower the risk of side effects. For example, certain drugs can help prevent nausea, vomiting, and low blood cell counts.1,2

These are not all the possible side effects of chemotherapy drugs. Talk to your doctor about what to expect when taking these drugs. You also should call your doctor if you have any changes that concern you when taking chemotherapy drugs.

Other things to know

Chemotherapy drugs for lung cancer are usually given as an intravenous (into the vein) injection or infusion. This is done in a doctor’s office, clinic, infusion center, or hospital. Your doctor will generally give the drugs in cycles. This gives you time to recover between each dose. The dosing schedule varies depending on the drugs used.1,2

If you respond well to treatment, you will typically undergo multiple of these cycles. Some doctors recommend ongoing treatment to help keep the cancer in check, which may be called maintenance therapy. If chemotherapy is not effective, your doctor may recommend other treatments.1,2

Before beginning treatment for lung cancer, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs.

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