NCCN Guidelines for Patients® | Non-Small Cell Lung Cancer - page 72

72
NCCN Guidelines for Patients
®
: Non-Small Cell Lung Cancer
Version 1.2014
Part 7: Treatment by cancer stage
First-line treatments
EGFR and ALK status: Unknown or negative
Histologic subtype
Performance
status score
Treatment options if cancer grows during
or after first-line treatments
Squamous cell carcinoma
0 or 1
Doublet chemotherapy
Cetuximab with cisplatin and vinorelbine
2
Single-agent or doublet chemotherapy
3 or 4
Best supportive care
Non-squamous subtypes
0 or 1
Doublet chemotherapy
Cetuximab with cisplatin and vinorelbine
Bevacizumab with platinum-doublet chemotherapy
2
Single-agent or doublet chemotherapy
3 or 4
Best supportive care
This chart lists first-line treatments for when EGFR and
ALK gene changes are unknown or absent. Treatment
options are based on performance status. You may be
treated with chemotherapy if your performance score is
between 0 and 2. Your doctors will choose a regimen
based on how well it will stop cancer growth compared
to how harmful it could be. A performance score of 3 or 4
suggests that chemotherapy will be too harmful. Therefore,
the best supportive care is recommended. Supportive care
treats the symptoms caused by the cancer but not the
cancer itself.
There are many chemotherapy drugs that are useful.
These drugs include cisplatin, carboplatin, paclitaxel,
docetaxel, vinorelbine, etoposide, pemetrexed, and
gemcitabine. The use of two drugs, call doublet
chemotherapy, works better than a single agent. However,
doublet chemotherapy will likely cause more side effects.
Often, cisplatin or carboplatin—chemotherapy drugs made
with platinum—is used with another drug. These regimens
are called platinum-doublet chemotherapy.
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