What are the recommendations for switch maintenance chemotherapy 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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Switch maintenance chemotherapy involves giving chemotherapy with agents different from those used in first-line therapy. This chemotherapy is started after completion of first-line chemotherapy and continued until disease progression or unacceptable toxicities occur. Switch maintenance therapy is associated with improvements in progression-free survival for all three agents listed below and improvements in overall survival for pemetrexed and erlotinib.

Switch maintenance chemotherapy regimens are as follows:

  • Docetaxel 75 mg/m2 IV every 21 d or

  • Pemetrexed 500 mg/m2 IV every 21 d [105] (non-squamous histology) or

  • Erlotinib 150 mg PO daily (1 h before or 2 h after meals) [106]

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