What are the adjuvant chemotherapy regimens for non-small cell lung cancer (NSCLC) stage I or II?

Updated: Jul 15, 2021
  • Author: Marvaretta M Stevenson, MD; Chief Editor: Nagla Abdel Karim, MD, PhD  more...
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Answer

Answer

With chemotherapy for stage IB or II NSCLC, the goal is to complete four cycles. Acceptable adjuvant chemotherapy regimens include the following:

  • Cisplatin 50 mg/m2 IV on days 1 and 8 plus  vinorelbine 25 mg/m2 IV on days 1, 8, 15, and 22 every 28 d [1, 2, 3, 4, 5, 6] or

  • Cisplatin 100 mg/m2 IV on day 1 plus  vinorelbine 30 mg/m2 on days 1, 8, 15, and 22 every 28 d [1, 2, 3, 4, 5, 6]  or

  • Cisplatin 75-80 mg/m2 IV on day 1 plus  vinorelbine 25-30 mg/m2 IV on days 1 and 8 every 21 d [1, 2, 3, 4, 5, 6]  or

  • Cisplatin 100 mg/m2 IV on day 1 plus  etoposide 100 mg/m2 IV on days 1-3 every 28 d [1, 2, 3]  or

  • Cisplatin 80 mg/m2 IV on days 1, 22, 43, and 64 plus  vinblastine 4 mg/m2 IV on days 1, 8, 15, 22, and 29; then  every 2 wk after day 43 until completion of cisplatin every 21 d [1, 2, 3]  or

  • Cisplatin 75 mg/m2 IV on day 1 plus  gemcitabine 1250 mg/m2 on days 1 and 8 every 21 d [7]  or

  • Cisplatin 75 mg/m2 IV on day 1 plus  docetaxel 75 mg/m2 IV on day 1 every 21 d [8]  or

  • Cisplatin 75 mg/m2 IV on day 1 plus  pemetrexed 500 mg/m2 IV on day 1 every 21 d (for non-squamous histologies) [7]

Patients with comorbidities or patients not able to tolerate cisplatin may alternatively use one of the following regimens for a goal of four cycles:

Consider the following in patients with completely resected stage IB-IIIA EGFR mutation–positive NSCLC who received previous adjuvant chemotherapy or are ineligible to receive platinum-based chemotherapy:

  • Osimertinib 80 mg PO daily, until disease recurrence, or unacceptable toxicity, or for up to 3 years [7]

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