Squamous cell carcinoma of the lung chemotherapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shanshan Cen, M.D. [2] Maria Fernanda Villarreal, M.D. [3]
Overview
Combination chemotherapy regimens using platinum-based chemotherapy and specific-inhibitors is the treatment of choice for the management of patients with squamous cell carcinoma of the lung. Chemotherapy may be required upon histological subtype of squamous cell carcinoma of the lung, molecular testing (presence of genetic mutations), and staging. In most cases, the predominant treatment of choice for squamous cell carcinoma of the lung is neoadjuvant chemotherapy or adjuvant chemotherapy, followed or preceded by surgical resection. Commonly used chemotherapeutic agents, include: cisplatin, erlotinib, paclitaxel, docetaxel, carboplatin, etoposide or vinorelbine.
Chemotherapy
- Initial chemotherapy for patients with squamous cell carcinoma of the lung will depend on molecular testing, the presence of particular genetic mutations, and staging.
- Chemotherapy for patients with squamous cell carcinoma of the lung, is divided into 2 main types: specific-inhibitor therapy (usually indicated with the presence of a genetic mutation) and platinum-based chemotherapy ( usually indicated with the absence of a genetic mutation)
- Combination chemotherapy regimens using platinum-based chemotherapy and specific-inhibitors is the treatment of choice for the management of patients with squamous cell carcinoma of the lung
- Erlotinib is the first-line treatment for patients with squamous cell carcinoma of the lung whose cancer has spread to other parts of the body and that has certain types of epidermal growth factor receptor (EGFR) mutations.
- Chemotherapy treatments for squamous cell carcinoma of the lung, include:[1][2]
- Paclitaxel:IV 175 mg/m2 over 3 hours every 3 weeks (as a single agent) for up to 5 cycles[3] or 80 mg/m2 over 1 hour weekly for 6 weeks of an 8-week treatment cycle (as a single agent) until disease progression or unacceptable toxicity.[4]
- Cisplatin
- 100 mg/m2 on day 1 every 4 weeks (in combination with etoposide) for 3 to 4 cycles;[5]
- 100 mg/m2 on day 1 every 4 weeks (in combination with vinorelbine)[6][7]
- 100 mg/m2 on day 1 every 4 weeks (in combination with gemcitabine)[8]
- 80 mg/m2 on day 1 every 3 weeks (in combination with gemcitabine)[9]
- 75 mg/m2 on day 1 every 3 weeks (in combination with pemetrexed) for up to 6 cycles or until disease progression or unacceptable toxicity[10]
- Erlotinib
- Afatinib
- Gefitinib
- Bevacizumab
- Crizotinib
- Vinorelbine[7]
- Gemcitabine[8]
- Carboplatin
- Etoposide
- Docetaxel
- Pemetrexed
- Platinum-based chemotherapy (cisplatin, carboplatin, etoposide, irinotecan) are the mainstay of squamous cell carcinoma of the lung
- Platinum-based chemotherapy consists of four to six cycles
- Cisplatin is the preferred platinum based agent of choice when the therapy is used with curative intent
- To see more information about mangnagment approach for non-small cell lung cancer click here
- To see more information about the chemotherapeutic regimens in non-small cell lung cancer click here
Complications
- Medical therapy complications for squamous cell carcinoma of the lung will depend on the chemotherapeutic agent.
- Common chemotherapy complications, include:[1]
- Platinum-based chemotherapy, the main dose-limiting side effect of cancer treatment with platinum compounds, include:
- Other chemotherapeutic agent complications, include:
- Side effects symptoms of chemotherapeutic agents, include:
References
- ↑ 1.0 1.1 Alberti, W; Anderson, G; Bartolucci, A; Bell, D; et al. Chemotherapy in non-small cell lung cancer: A meta-analysis using updated data on individual patients from 52 randomised clinical trials. British Medical Journal, International edition311.7010 (Oct 7, 1995): 899
- ↑ Moran T, Sequist L. Timing of Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor Therapy in Patients With Lung Cancer With EGFR Mutations. J Clin Oncol 2012; 30:3330
- ↑ Smit EF, Fokkema E, Biesma B, Groen HJ, Snoek W, Postmus PE (1998). "A phase II study of paclitaxel in heavily pretreated patients with small-cell lung cancer". Br. J. Cancer. 77 (2): 347–51. PMC 2151229. PMID 9461009.
- ↑ Yamamoto N, Tsurutani J, Yoshimura N, Asai G, Moriyama A, Nakagawa K, Kudoh S, Takada M, Minato Y, Fukuoka M (2006). "Phase II study of weekly paclitaxel for relapsed and refractory small cell lung cancer". Anticancer Res. 26 (1B): 777–81. PMID 16739353.
- ↑ Arriagada R, Bergman B, Dunant A, Le Chevalier T, Pignon JP, Vansteenkiste J (January 2004). "Cisplatin-based adjuvant chemotherapy in patients with completely resected non-small-cell lung cancer". N. Engl. J. Med. 350 (4): 351–60. doi:10.1056/NEJMoa031644. PMID 14736927.
- ↑ Kelly K, Crowley J, Bunn PA, Presant CA, Grevstad PK, Moinpour CM, Ramsey SD, Wozniak AJ, Weiss GR, Moore DF, Israel VK, Livingston RB, Gandara DR (July 2001). "Randomized phase III trial of paclitaxel plus carboplatin versus vinorelbine plus cisplatin in the treatment of patients with advanced non--small-cell lung cancer: a Southwest Oncology Group trial". J. Clin. Oncol. 19 (13): 3210–8. doi:10.1200/JCO.2001.19.13.3210. PMID 11432888.
- ↑ 7.0 7.1 Wozniak AJ, Crowley JJ, Balcerzak SP, Weiss GR, Spiridonidis CH, Baker LH, Albain KS, Kelly K, Taylor SA, Gandara DR, Livingston RB (July 1998). "Randomized trial comparing cisplatin with cisplatin plus vinorelbine in the treatment of advanced non-small-cell lung cancer: a Southwest Oncology Group study". J. Clin. Oncol. 16 (7): 2459–65. doi:10.1200/JCO.1998.16.7.2459. PMID 9667264.
- ↑ 8.0 8.1 Comella P, Frasci G, Panza N, Manzione L, De Cataldis G, Cioffi R, Maiorino L, Micillo E, Lorusso V, Di Rienzo G, Filippelli G, Lamberti A, Natale M, Bilancia D, Nicolella G, Di Nota A, Comella G (April 2000). "Randomized trial comparing cisplatin, gemcitabine, and vinorelbine with either cisplatin and gemcitabine or cisplatin and vinorelbine in advanced non-small-cell lung cancer: interim analysis of a phase III trial of the Southern Italy Cooperative Oncology Group". J. Clin. Oncol. 18 (7): 1451–7. doi:10.1200/JCO.2000.18.7.1451. PMID 10735892.
- ↑ Ohe Y, Ohashi Y, Kubota K, Tamura T, Nakagawa K, Negoro S, Nishiwaki Y, Saijo N, Ariyoshi Y, Fukuoka M (February 2007). "Randomized phase III study of cisplatin plus irinotecan versus carboplatin plus paclitaxel, cisplatin plus gemcitabine, and cisplatin plus vinorelbine for advanced non-small-cell lung cancer: Four-Arm Cooperative Study in Japan". Ann. Oncol. 18 (2): 317–23. doi:10.1093/annonc/mdl377. PMID 17079694.
- ↑ Scagliotti GV, Parikh P, von Pawel J, Biesma B, Vansteenkiste J, Manegold C, Serwatowski P, Gatzemeier U, Digumarti R, Zukin M, Lee JS, Mellemgaard A, Park K, Patil S, Rolski J, Goksel T, de Marinis F, Simms L, Sugarman KP, Gandara D (July 2008). "Phase III study comparing cisplatin plus gemcitabine with cisplatin plus pemetrexed in chemotherapy-naive patients with advanced-stage non-small-cell lung cancer". J. Clin. Oncol. 26 (21): 3543–51. doi:10.1200/JCO.2007.15.0375. PMID 18506025.