7 Most Effective Chemotherapy Drugs for Lung Cancer

As the leading cause of cancer death worldwide, lung cancer annually claims the lives of over 150,000 people in the U.S. While the majority of lung cancer cases are the result of cigarette smoking, exposure to toxic agents such as radon gas, secondhand tobacco smoke or asbestos represents a serious risk factor as well. However, it is worthy of note that when it is caused by asbestos exposure, lung cancer develops differently and has a significantly longer latency period than tobacco-related lung cancer. Fibers of asbestos in the lungs produce tissue inflammation and scarring gradually and the onset of the disease occurs within 15-35 years of first exposure.

Regardless of its cause, there are two types of lung cancer:

• Non-small cell lung cancer. With this type of lung cancer, the cells which make up the tumor are large. It accounts for approximately 85% of all cases and has three subtypes: adenocarcinoma (the most common subtype, which starts growing in the air sacs of the lungs), squamous cell carcinoma (it begins developing in the inner airways) and large cell carcinoma (a more aggressive subtype which tends to spread more rapidly).
• Small cell lung cancer. The cells are small and round. It affects roughly 15% of all lung cancer patients. Small cell lung cancer is more aggressive than the non-small cell type and also spreads more quickly through the bloodstream.

Sometimes, the two types can overlap, which leads to a mixed small cell/ non-small cell lung cancer diagnosis. Nevertheless, this occurrence is rather rare.

As for most forms of cancer, chemotherapy is vital in the treatment of lung cancer. It can greatly improve your prognosis, extend your life expectancy and, if the disease is detected early, even cure it. We have selected the most effective drugs used in chemotherapy for non-small cell and small cell lung cancer, as well as some of the most beneficial drug combinations.

5 Most Beneficial Drugs for Non-Small Cell Lung Cancer

1. Docetaxel (Taxotere, Docefrez)

Docetaxel is a plant alkaloid which attacks cancer cells during their division phases. By inhibiting their microtubule structure, the cells can no longer replicate themselves, which ultimately results in cell death. The drug is administered intravenously over the course of one hour, generally every 3 weeks. Before starting treatment, it is recommended to take a corticosteroid pill in order to reduce the severity of side effects.

A combination of docetaxel and gemcitabine has proved to be very efficient in the treatment of metastatic non-small-cell lung cancer. 44% of the patients involved in the second phase of a clinical trial experienced partial remission after receiving this combination, while 6% of them had a complete response. The average survival period was 13 months. Moreover, for 29% of the lung cancer patients, the disease ceased to progress for approximately 6 months following chemotherapy with docetaxel and gemcitabine.

Cisplatin, a drug which is also successfully used in the treatment of pleural mesothelioma, and docetaxel is another beneficial combination for non-small cell lung cancer. According to the results of various clinical trials, the response rate varies between 30 and 51 percent and the median survival is roughly 10 months.

The side effect most commonly associated with docetaxel include:

• fluid retention
• low red blood cell count
• low white blood cell count
• nausea
• fatigue
• numbness in fingers and toes

2. Paclitaxel (Abraxane, Taxol, Onxal)

As another plant alkaloid, paclitaxel also prevents cancer cells from spreading further by inhibiting their reduplication. This anti-cancer drug is typically used in combination with carboplatin for increased efficiency. Of the 66 non-small cell lung cancer patients who participated in a 1998 clinical trial, 41% experienced partial remission, while 12% achieved a complete response. Similarly, treatment with paclitaxel and cisplatin has shown remarkable results in non-small cell lung cancer patients.

Paclitaxel is delivered intravenously over the course of one, three or twenty-four hours. The dose and frequency of treatment will depend on the particularities of each case. Because it can occasionally cause allergic reactions, your physician may prescribe certain medication to take prior to chemotherapy.

Some of the most common side effects of this drug are:

• low red and white blood cell counts
• nausea and vomiting
• mouth sores
• diarrhea
• pain in muscles and joints
• hair loss
• fever or chills
• blurred vision
• skin rash

3. Erlotinib (Tarceva)

Erlotinib is a chemotherapy drug used in targeted therapy. It is particularly effective for advanced and metastatic non-small cell lung cancer. This drug destroys cancer cells by targeting the EGFR (epidermal growth factor) protein, which is found on the surface of cells, and inhibiting the tyrosine kinase enzyme. Erlotinib comes in tablet form and is taken orally on an empty stomach, one hour before or two hours after eating. The recommended dose is 150 mg per day. However, it can vary depending on the health condition of each patient.

The results of a randomized clinical trial comparing erlotinib with platinum-based doublet chemotherapy revealed that non-small lung cancer patients who received the former had a progression-free survival of 10.4 months, an overall survival of 22.9 months and an objective response rate of 65%.

Side effects of erlotinib include:

• loss of appetite
• shortness of breath
• rash
• cough
• fatigue
• diarrhea
• nausea and vomiting
• tingling or numbness in arms and legs

4. Nivolumab (Opdivo)

This anti-cancer drug is also involved in targeted therapy. It inhibits the growth of cancer tumors and is highly beneficial for patients with advanced or metastatic non-small cell lung cancer whose disease has not improved after platinum-based chemotherapy. Nivolumab is delivered intravenously over the course of one hour, typically every two weeks.

A combination of nivolumab and ipilimumab is sometimes prescribed for non-small cell lung cancer, which has been associated with positive results. The overall response rate ranges between 39 and 47 percent and the progression-free survival is 8 months. Additionally, treatment with nivolumab and ipilimumab is not usually accompanied by severe side effects.

Some of the most frequently experienced side effects of nivolumab are:

• low white blood cells count
• loss of appetite
• fatigue
• muscle pain
• cough
• low sodium levels
• shortness of breath

5. Vinorelbine (Navelbine)

Vinorelbine is an antineoplastic chemotherapy drug which destroys cancer cells by inhibiting their reproduction. It is administered intravenously over 10 minutes, once a week. Treatment with vinorelbine's and cisplatin is recommended in conjunction with radiation therapy in certain cases. However, cisplatin may increase the severity of vinorelbine's side effects and thereby, premedication may also be prescribed with this treatment regimen.

In a 2000 clinical trial, 120 patients diagnosed with non-small cell lung cancer received vinorelbine as a single chemotherapy drug. A complete response was reported in 4 patients and 23 of them had a partial response, while the tumors of 25 others have not progressed following treatment.

The following side effects are often associated with vinorelbine:

• low red blood cell count
• low white blood cell count
• constipation
• nausea and vomiting
• fever or chills
• cough
• muscle weakness

2 Most Beneficial Drugs for Small Cell Lung Cancer

1. Etoposide (Toposar, Etopophos, VePesid)

Etoposide is another antineoplastic chemotherapy drug. For small cell lung cancer, it is usually employed in combination with a platinum-based drug such as carboplatin or cisplatin. It is delivered intravenously as a short infusion or over the course of 24 hours. Etoposide also comes in tablet form.

The side effects of this chemotherapy drug include:

• low platelet count
• low white blood cell count
• nausea and vomiting
• loss of fertility
• shortness of breath
• fever
• low blood pressure

2. Irinotecan (Camptosar)

A combination of irinotecan and cisplatin or carboplatin is often used in the treatment of small cell lung cancer, being associated with good response rates. Irinotecan, a plant alkaloid, attacks cancer cells during their division phases to inhibit their further growth. The drug is administered intravenously over 90 minutes.

Some of the most frequent side effects of irinotecan are:

• diarrhea
• nausea and vomiting
• low red blood cell count
• low white blood cell count
• fatigue
• loss of appetite
• fever
• weight loss