What are the single-agent therapy recommendations for non-small cell lung cancer (NSCLC) stage IV or recurrent disease?

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

Answer

Single-agent therapy is a reasonable first-line option in patients with good performance status (ECOG score ≤2) disease or in the elderly; the goal is to complete four to six cycles. Systemic chemotherapy is not indicated for patients with poor performance status (ECOG 3-4), except for erlotinib in patients who are EGFR-mutation positive. [7]

Single-agent regimens include the following:

  • Paclitaxel 200 mg/m2 IV every 21 d [54, 55]  or

  • Docetaxel 35 mg/m2 IV weekly for 3 wk every 4wk [50, 56, 57, 58]  or

  • Docetaxel 75 mg/m2 IV every 21 d [56, 59, 60, 57]  or

  • Gemcitabine 1000 mg/m2 IV on days 1, 8, and 15 every 4 wk [61, 62]  or

  • Gemcitabine 1250 mg/m2 IV on days 1 and 8 every 21 d [38, 51]  or

  • Vinorelbine 25 mg/m2 IV weekly [63, 64]  or

  • Vinorelbine 30 mg/m2 IV on days 1 and 8 every 21d [51, 65, 66]  or

  • Pemetrexed 500 mg/m2 IV every 21d [67]  (non-squamous histology)


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