Lung Cancer Treatment Options

Your lung cancer treatment team will evaluate your situation and create a personalized treatment plan using the most current national guidelines and practice standards. Your team will consider your overall health, including the health of your lungs, your type and subtype of lung cancer, and cancer stage.

Lung cancer treatments continue to evolve and our disease-specific experts work tirelessly to stay at the forefront. We strive to find the most current and effective treatment or combination of treatments. We also offer clinical trials for eligible patients.

Our Multidisciplinary Tumor Board

The Thoracic Cancer Program includes a complete, caring team of specialist physicians with expertise in every treatment option. These physicians work closely together, giving every patient fully coordinated care that offers the best chance for survival. In the Thoracic Cancer Program, the experts specialize in treating only thoracic cancers, which means they have extensive experience in treating all stages of disease. They are using, testing, and discovering the latest treatment advances possible.

Our multidisciplinary tumor boards and the broad experience of the specialists who attend the tumor boards may be one of the most important benefits for our patients.

Our specialists meet regularly to review and discuss most patients. Multidisciplinary tumor boards offer a comprehensive, coordinated approach to arrive at the best treatment plan for each person.

The tumor board approach means a patient gets the opinion of every type of specialist involved in the program — including thoracic surgeons, radiation oncologists, medical oncologists, radiologists, interventional radiologists, pulmonologists and pathologists. 

Some patients may be reviewed again at tumor board meetings to adjust the treatment plan if necessary or revisit the patient’s progress after treatment.

Treatment for Non-Small Cell Lung Cancer

For non-small cell lung cancer, treatment is often a combination of surgery, radiation therapy and medical therapy. 

NSCLC Treatment by Stage

The specific combination and sequence (order in which treatment is given) depends on the subtype of non-small cell lung cancer and extent of disease (stage). 

Early-Stage (I-II)

• Surgery (lobectomy, pneumonectomy, or segmentectomy)
• Radiation therapy may be used before surgery (usually with chemotherapy) to shrink a tumor, or after surgery (alone or with chemotherapy) to eliminate cancer cells that may remain.
• Adjuvant chemotherapy (chemo after surgery to reduce the risk of cancer returning)
• Targeted therapies (if gene mutations like EGFR, ALK are present), are drugs that target specific molecules like proteins inside or on the outside of cancer cells. These molecules tell cancer cells to grow and multiply. The targeted drugs interrupt this process.
• Immunotherapies are medications that “turn on” white blood cells called T cells to eradicate cancer cells. Immunotherapy may be an option before surgery in combination with chemotherapy, or after surgery and adjuvant chemotherapy.

Locally Advanced (Stage III)

• Chemoradiation (combined chemotherapy and radiation)
• Immunotherapy (after chemoradiation)
• Chemotherapy plus immunotherapy before surgery for patients who have lung tumors that can be surgically removed

Advanced/Metastatic (Stage IV)

• Targeted therapy for gene mutations - Molecular testing is done to determine the right targeted treatment, depending on the type of mutation.
• Immunotherapy – PDL-1 testing guides immunotherapy decisions.
• Chemotherapy - Often, a combination of chemotherapy drugs is used, depending on biomarker status
• Radiation therapy may be used to reduce cancer-related symptoms or to prevent of symptoms from developing

Treatment for Small Cell Lung Cancer

For small cell lung cancer there is usually less of a role for surgery. More often, a combination of systemic therapy and radiation therapy is recommended.

Limited Stage

• Chemotherapy + radiation therapy
• Prophylactic cranial irradiation, also called PCI, is radiation therapy to the head to prevent metastasis to the brain; brain metastasis is common with small cell lung cancer
• Immunotherapy after chemoradiation

Extensive Stage

• Chemotherapy + immunotherapy
  • A targeted immunotherapy called bispecific antibody T-cell engager therapy (for select patients when their cancer has returned after chemotherapy)
• Radiation therapy may be used to control symptoms