Lung Chemotherapy Regimens

The information contained in these regimens is a statement of consensus of NCCP and ISMO or IHS professionals regarding their views of currently accepted approaches to treatment. Any clinician seeking to apply or consult these documents is expected to use independent medical judgement in the context of individual clinical circumstances to determine any patient's care or treatment. The treatment regimen to be used should take into account factors such as histology, molecular pathology, age, performance status, co-morbidities and the patient’s preference.Each treatment regimen has advantages and disadvantages, and there may be more than one good option.  In addition, treatment choices can change over time as more evidence becomes available.Use of these documents is the responsibility of the prescribing clinician and is subject to the HSE.ie terms of use.

Please email any comments or feedback on these regimens to oncologydrugs@cancercontrol.ie.

Lung Chemotherapy Regimens

Regimen Name Indication

Afatinib Monotherapy

Regimen 

00221a

Treatment of EGFR TKI- naïve adult patients with locally advanced or metastatic NSCLC with activating EGFR mutation(s).

Alectinib Monotherapy

Regimen

00401a

Treatment of adult patients with anaplastic lymphoma kinase (ALK)-positive advanced non-small cell lung cancer (NSCLC) previously treated with crizotinib

Bevacizumab 15mg/kg Therapy- 21 day

Regimen

00215e

In combination with erlotinib is indicated for the first-line treatment of adult patients with unresectable advanced, metastatic or recurrent non-squamous cell lung cancer with Epidermal Growth Factor (EGFR) activating mutations.

Bevacizumab 7.5 mg/kg –21 days

Regimen

00214b

In addition to platinum-based chemotherapy is indicated for first-line treatment of adult patients with unresectable advanced, metastatic or recurrent non-small cell lung cancer (NSCLC) other than predominantly squamous cell histology.

Bevacizumab 15 mg/kg –21 days

Regimen

00215f

In addition to platinum-based chemotherapy is indicated for first-line treatment of adult patients with unresectable advanced, metastatic or recurrent non-small cell lung cancer (NSCLC) other than predominantly squamous cell histology.

Carboplatin + Etoposide Therapy

Regimen

00271a

Small cell lung cancer (SCLC) extensive disease.

Carboplatin and Oral Etoposide Therapy

Regimen

00319a

Small cell lung cancer (SCLC) extensive disease.

Carboplatin (AUC6) and Paclitaxel 200mg/m2 Therapy*

Regimen

00304a

Adjuvant Treatment of Stage I,II and IIIA Non Small Cell Lung Cancer( NSCLC)*

00304b

Treatment of locally advanced, recurrent or metastatic NSCLC*

Weekly Carboplatin and Paclitaxel Therapy with Radiotherapy

Regimen

00309a

Stage III Non small cell lung cancer (NSCLC)*

Ceritinib Monotherapy

Regimen

00340a

Treatment of adult patients with anaplastic lymphoma kinase (ALK)-positive advanced non-small cell lung cancer (NSCLC) previously treated with crizotinib.

Cisplatin + Etoposide

Regimen

00280a

Small cell lung cancer (SCLC) extensive disease

Cisplatin + Etoposide + Thoracic Radiotherapy (TRT)

Regimen

00279a

Small cell lung cancer (SCLC) limited disease

Crizotinib Monotherapy

Regimen

00243a

Treatment of adults with previously treated ALK-positive advanced NSCLC

Docetaxel Monotherapy 75mg/m2 – 21 day cycle

Regimen

00203a

Treatment of locally advanced or metastatic NSLC after failure of prior chemotherapy

Erlotinib Monotherapy

Regimen

00219a

First-line treatment of patients with locally advanced or metastatic non- small cell lung cancer (NSCLC) with EGFR activating mutations.

00219b

Switch maintenance treatment in patients with locally advanced or metastatic NSCLC with EGFR activating mutations and stable disease after first-line chemotherapy.

00219c

Treatment of patients with locally advanced or metastatic NSCLC after failure of at least one prior chemotherapy regimen.

Oral Etoposide Therapy

Regimen

00388a

Small cell lung cancer (SCLC) extensive disease in patients unsuitable for intravenous or combination chemotherapy.

Gefitinib Monotherapy

Regimen

00220a

Treatment of adult patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) with activating mutations of EGFR-TK

Gemcitabine Monotherapy-Locally Advanced or Metastatic

Regimen

00283b

Treatment of elderly patients or patients with ECOG =2 with locally advanced or metastatic non-small cell lung cancer (NSCLC).

Gemcitabine + Carboplatin (AUC5) Therapy-21 days

Regimen

00310b

Treatment of patients with locally advanced, recurrent or metastatic non small cell lung cancer (NSCLC)*

Gemcitabine + Cisplatin Therapy-21days

Regimen

00281a

Treatment of patients with locally advanced or metastatic non-small cell lung cancer (NSCLC)


Nintedanib Therapy

Regimen

00372a

In combination with docetaxel for the treatment of adult patients with locally advanced, metastatic of stage IIIB or IV, or locally recurrent NSCLC of adenocarcinoma tumour histology after first-line chemotherapy.

Paclitaxel Monotherapy 80mg/m2-7day cycle

Regimen

00226d

Relapsed or refractory small cell lung cancer.

Pemetrexed Monotherapy

Regimen

00222a

Maintenance treatment of locally advanced or metastatic non-small cell lung cancer other than predominantly squamous cell histology in patients who disease has not progressed immediately following platinum-based chemotherapy.

00222b

Second line treatment of patients with locally advanced or metastatic NSLC other than predominantly squamous cell histology.

Pemtrexed and Cisplatin Therapy

Regimen

00317a

Treatment of chemotherapy naïve patients with unresectable malignant pleural mesothelioma.

00317b

First line treatment of patients with locally advanced or metastatic non-small cell lung cancer (NSCLC).

Pemetrexed and Carboplatin Therapy

Regimen

00318a

Treatment of chemotherapy naïve patients with unresectable malignant pleural mesothelioma.

00318b

First line treatment of patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) other than predominantly squamous cell histology.

Oral Vinorelbine Monotherapy 7 days

Regimen

00259b

Non small cell lung cancer  (NSLC)

Intravenous Vinorelbine Therapy-21 days

Regimen

00232b

Non small cell lung cancer (NSLC)

Cisplatin + Etoposide + Thoracic Radiotherapy (TRT)

Regimen

00279a

Small cell lung cancer (SCLC) limited disease.

Topotecan Monotherapy-5 day

Regimen

00311b

Treatment of patients with relapsed small cell lung cancer (SCLC) for whom re-treatment with the first-line regimen is not considered appropriate.

Vinorelbine and Cisplatin Therapy-21 days

Regimen

00339a

Adjuvant treatment of patients with completely resected stage IB, ll or lllA non small cell lung cancer (NSLC).

00339b

Treatment of locally advanced recurrent or metastatic NSCLC.

Vinorelbine and Cisplatin Therapy-28 days

Regimen

00343a

Adjuvant treatment of patients with completely resected stage IB, ll or lllA non small cell lung cancer (NSLC).

00343b

Treatment of locally advanced recurrent or metastatic NSCLC.

 * Unlicensed indication. See regimen for more details