Drugs Used in Lung Cancer Maintenance Therapy

Following the completion of your prescribed cycles of first-line treatment your lung cancer is now under control and stable. You may then be placed under maintenance therapy to prolong this favorable, stable state while delaying cancer progression.

Platinum drugs, like cisplatin and carboplatin, are standard-of-care first-line therapy for advanced non-small cell lung cancer (NSCLC). They are dropped from the regimen during maintenance therapy, due to severe toxicity.

An ongoing administration of a component from the initial therapy is called continuation maintenance therapy. Typically, the maintenance component can be

• A non-platinum chemotherapeutic agent
• An immune checkpoint inhibitor (ICI) or
• A targeted drug

Sometimes your doctor may prescribe a customized combination of medication. For example, the U.S. Food and Drug Administration (FDA) has approved the combination of bevacizumab with pemetrexed or paclitaxel as maintenance therapy for advanced non-squamous NSCLC.

If you have experienced adverse effects during induction therapy, a drug with a different mode of action may be prescribed in the maintenance therapy. This is the switch maintenance therapy.

In the case of progressed patients, the treatment strategy includes reintroducing drugs from induction treatment or another drug that does not share cross-resistance with previous treatments. The maintenance therapy is then continued until either the disease shows signs of progression or when treatment-related toxicity necessitates the discontinuation of treatment.

To help you recognize the drugs mentioned in this article, we have listed them below with their brand names:

• Abraxane® (albumin-bound paclitaxel)
• Alimta® (pemetrexed)
• Avastin® (bevacizumab)
• Gemzar® (gemcitabine)
• IMFINZI® (durvalumab)
• Keytruda® (pembrolizumab)
• LIBTAYO® (cemiplimab)
• Navelbine® (vinorelbine)
• Opdivo® (nivolumab)
• Paraplatin® (carboplatin)
• Platinol® (cisplatin)
• Taxol® (paclitaxel)
• Taxotere® (docetaxel)
• Tecentriq® (atezolizumab)
• VePesid® or Etopophos® (etoposide)
• Yervoy® (ipilimumab)

Like any other cancer therapy, maintenance therapy is personalized and tailored to each patient's medical condition. It ensures the approach is customized to meet their needs and optimize treatment outcomes while minimizing toxicities.

Related: Maintenance Therapy in Lung Cancer: Who, What, Why, When, How