Non-Small Cell Lung Cancer Stages

non-small-cell -lung -cancer-4 stages

Non-small cell lung cancer stages define the type of the patient’s treatment. Hence, different types of treatments are available for patients with non-small cell lung cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials.

Non-small Cell Lung Cancer Stages Treatment

Treatment of occult non-small cell lung cancer depends on the stage of the disease. Occult tumors are often found at an early stage (the tumor is in the lung only) and sometimes can be cured by surgery.

Treatment of stage 0 may include the following:

  • Surgery (wedge resection or segmental resection).
  • Photodynamic therapy, electrocautery, cryosurgery, or laser surgery for tumors in or near the bronchus.

Non-small Cell Lung Cancer Stages – Treatment of stage IA non-small cell lung cancer and stage IB non-small cell lung cancer may include the following:

  • Surgery (wedge resection, segmental resection, sleeve resection, or lobectomy).
  • External radiation therapy, including stereotactic body radiation therapy for patients who cannot have surgery or choose not to have surgery.
  • clinical trial of chemotherapy or radiation therapy following surgery.
  • A clinical trial of treatment given through an endoscope, such as photodynamic therapy (PDT).
  • A clinical trial of surgery followed by chemoprevention.

Treatment of stage IIA non-small cell lung cancer and stage IIB non-small cell lung cancer may include the following:

  • Surgery (wedge resection, segmental resection, sleeve resection, lobectomy, or pneumonectomy).
  • Chemotherapy followed by surgery.
  • Surgery followed by chemotherapy.
  • External radiation therapy for patients who cannot have surgery.
  • A clinical trial of radiation therapy following surgery.

Treatment of stage IIIA non-small cell lung cancer that can be removed with surgery may include the following:

  • Surgery followed by chemotherapy.
  • Surgery followed by radiation therapy.
  • Chemotherapy followed by surgery.
  • Surgery followed by chemotherapy combined with radiation therapy.
  • Chemotherapy and radiation therapy followed by surgery.
  • A clinical trial of new combinations of treatments.

Treatment of stage IIIA non-small cell lung cancer that cannot be removed with surgery may include the following:

  • Chemotherapy and radiation therapy given over the same period of time or one followed by the other.
  • External radiation therapy alone for patients who cannot be treated with combined therapy, or as palliative treatment to relieve symptoms and improve the quality of life.
  • Internal radiation therapy or laser surgery, as palliative treatment to relieve symptoms and improve the quality of life.
  • Chemotherapy and radiation therapy followed by immunotherapy with an immune checkpoint inhibitor, such as durvalumab.
  • A clinical trial of new combinations of treatments.

    Non-small cell lung cancer of the superior sulcus, often called Pancoast tumor, begins in the upper part of the lung and spreads to nearby tissues such as the chest wall, large blood vessels, and spine. Treatment of Pancoast tumors may include the following:

    • Radiation therapy alone.
    • Surgery.
    • Chemotherapy and radiation therapy followed by surgery.
    • A clinical trial of new combinations of treatments.

    Some stage IIIA non-small cell lung tumors that have grown into the chest wall may be completely removed. Treatment of chest wall tumors may include the following:

    • Surgery.
    • Surgery and radiation therapy.
    • Radiation therapy alone.
    • Chemotherapy combined with radiation therapy and/or surgery.
    • A clinical trial of new combinations of treatments.

Treatment of stage IIIB non-small cell lung cancer and stage IIIC non-small cell lung cancer may include the following:

  • Chemotherapy followed by external radiation therapy.
  • Chemotherapy and radiation therapy given as separate treatments over the same period of time.
  • Chemotherapy and radiation therapy given as separate treatments over the same period of time, with the dose of radiation therapy increasing with time.
  • Chemotherapy and radiation therapy given as separate treatments over the same period of time. Chemotherapy alone is given before or after these treatments.
  • Chemotherapy and radiation therapy followed by immunotherapy with an immune checkpoint inhibitor, such as durvalumab.
  • External radiation therapy alone for patients who cannot be treated with chemotherapy.
  • External radiation therapy as palliative therapy, to relieve symptoms and improve the quality of life.
  • Laser therapy and/or internal radiation therapy to relieve symptoms and improve the quality of life.
  • Clinical trials of new external radiation therapy schedules and new types of treatment.
  • A clinical trial of chemotherapy and radiation therapy combined with a radiosensitizer.
  • Clinical trials of targeted therapy combined with chemotherapy and radiation therapy.
  • Combination chemotherapy.
  • Combination chemotherapy and targeted therapy with a monoclonal antibody, such as bevacizumab, cetuximab, or necitumumab.
  • Combination chemotherapy followed by more chemotherapy as maintenance therapy to help keep cancer from progressing.
  • Targeted therapy with an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, such as osimertinibgefitiniberlotinib, or afatinib.
  • Targeted therapy with an anaplastic lymphoma kinase (ALK) inhibitor, such as alectinib, crizotinib, ceritinib, brigatinib, or lorlatinib.
  • Targeted therapy with a BRAF or MEK inhibitor, such as dabrafenib or trametinib.
  • Targeted therapy with a NTRK inhibitor, such as larotrectinib.
  • Immunotherapy with an immune checkpoint inhibitor, such as pembrolizumab, with or without chemotherapy.
  • Laser therapy and/or internal radiation therapy for tumors that are blocking the airways.
  • External radiation therapy as palliative therapy, to relieve symptoms and improve the quality of life.
  • Surgery to remove a second primary tumor.
  • Surgery to remove cancer that has spread to the brain, followed by radiation therapy to the whole brain.
  • Stereotactic radiosurgery for tumors that have spread to the brain and cannot be treated with surgery.
  • clinical trial of new drugs and combinations of treatments.

Treatment of progressive stage IV, relapsed, and recurrent non-small cell lung cancer may include the following:

  • Chemotherapy.
  • Targeted therapy with an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, such as erlotinib, gefitinib, afatinib, or osimertinib.
  • Targeted therapy with an anaplastic lymphoma kinase (ALK) inhibitor, such as crizotinib, ceritinib, alectinib, or brigatinib.
  • Targeted therapy with a BRAF or MEK inhibitor, such as dabrafenib or trametinib.
  • Immunotherapy with an immune checkpoint inhibitor, such as nivolumab, pembrolizumab, or atezolizumab.
  • A clinical trial of new drugs and combinations of treatments.

Non-Small Cell Lung Cancer Treatment “ (PDQ®)–Patient Version was originally published by the National Cancer Institute.”

PDQ® Adult Treatment Editorial Board. PDQ Non-Small Cell Lung Cancer Treatment. Bethesda, MD: National Cancer Institute. Updated <10/16/2019>. Available at: https://www.cancer.gov/types/lung/patient/non-small-cell-lung-treatment-pdq. Accessed <12/13/2019>. [PMID: 26389355].