Table of ContentsView AllTable of ContentsHow It WorksGoalsMedicationsWho Benefits Most?Side EffectsWhen to Stop

Table of ContentsView All

View All

Table of Contents

How It Works

Goals

Medications

Who Benefits Most?

Side Effects

When to Stop

Lung cancer maintenance therapy is ongoing therapy that is administered after the acute phase of treatment has been completed. In the case of lung cancer, you would undergo first-line chemotherapy for a limited period of time, and then you might receive maintenance therapy to keep the cancer in check. The goal is to improve quality of life while offering a chance for longer survival.

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How Maintenance Therapy Works

Maintenance therapy is often part of the treatment strategy foradvanced lung cancerthat’s not fully curable with surgery orradiation.

Maintenance therapy is used for disease management, not to cure disease. The goal is to achieve longerprogression-free survival(the amount of time you can live without cancer growing). But it’s important to know that maintenance therapy does more than palliative treatment, which focuses only on easing symptoms.

Supporting Chemotherapy Treatment

Maintenance therapy is increasingly used in managingnon-small cell lung cancer(NSCLC).Stage 3A,stage 3B, orstage 4NSCLC is treated with chemotherapy. A combination of drugs can often stopmetastatic lung cancerfrom spreading.

Standard treatment for NSCLC includes several cycles ofchemotherapythat may include platinum drugs, like carboplatin, combined with targeted therapy and/or immunotherapy.Beyond that, most patients would experience unacceptable levels of toxicity andside effectsthat would severely impact their health.

Once a course of chemotherapy is completed, cancer could begin growing again. To limit cancer growth after the standard course of chemotherapy, your healthcare provider may recommend maintenance therapy. Some of the drugs that were used during initial treatment cycles may be continued, but certain drugs might not be used during maintenance therapy to avoid toxicity.

Maintenance therapy is focused on maintaining a state in which cancer is under control. You are likely to stay on this treatment unless you develop side effects or if there’s evidence that the tumors are growing and spreading again.

What is health maintenance for lung cancer?Health maintenance is a different concept than maintenance therapy. This term is typically used to describe actions you might take to maintain your health while you are undergoing treatment, such as quitting smoking, getting an annual flu shot, and managing any other chronic medical conditions you might have.

What is health maintenance for lung cancer?

Health maintenance is a different concept than maintenance therapy. This term is typically used to describe actions you might take to maintain your health while you are undergoing treatment, such as quitting smoking, getting an annual flu shot, and managing any other chronic medical conditions you might have.

Goals of Maintenance Therapy

There are several ways that maintenance therapy can help NSCLC patients:

Maintenance Therapy Drugs

Your healthcare providers will consider several factors when choosing which type of medications to prescribe for maintenance therapy. The combination can include a non-platinum-based chemotherapy drug; an immunotherapy drug that boosts your immune system; and/or atargeted therapydrug.

When maintenance therapy includes a drug that was part of the initial treatment, it may be calledcontinuation maintenance. When a different drug is introduced, it may be calledswitch maintenance.

Examples of immunotherapy drugs approved for maintenance therapy include:

Like other immunotherapy medications, Imfinzi helps your own immune system fight cancer. Unlike other maintenance therapies, Imfinzi is also approved for lung cancer treatment alone or combined with Imjudo and platinum-based chemotherapy.

Targeted therapy drugs that have been approved for maintenance therapy include Avastin(bevacizumab). As a man-made therapy that stops the growth of blood vessels, Avastin is an example of continuation maintenance.

Who Benefits Most From Maintenance Therapy?

As with most treatments for lung cancer, there are certain people who respond much better than others to therapy.

Studies of Alimta have shown that it seems to be more effective for people withlung adenocarcinoma. In fact, it seems to extend thelung cancer survival ratesignificantly in patients with that type of NSCLC who use Alimta for maintenance therapy.

Maintenance chemotherapy can have side effects and complications that can range from mild to severe.

Those who are highly sensitive may still suffer some of the commonside effects of chemotherapywhile on Alimta alone.

These include:

Other serious side effects may include male infertility, low blood cell counts, kidney problems, skin irritation, andpneumonitis(inflammation of the lungs).

Avastin, like other targeted therapy drugs, offers the chance for good outcomes without the more inconvenient or serious side effects associated with chemotherapy. There are still some drawbacks to these drugs, though. The most common is skin rash.

Approximately 90% of patients on targeted therapy drugs that act onEGFR mutationsdevelop an acne-like skin rash within two weeks of starting treatment.For the most part, though, the skin rash can be managed with over-the-counter creams or prescription treatments.

Immunotherapy drugs boost the immune system to help you fight cancer, but once the immune system is revved up, it may also attack healthy tissue. This can affect the pulmonary, intestinal, and renal systems, among others.

That said, the most common side effects of the immunotherapy drug Imfinzi, for example, include:

Other ConsiderationsWhile maintenance therapy offers those with inoperable lung cancer some hope, the benefits need to be weighed against some negative factors.Cost: Medications designed for maintenance can be very expensive. Your insurance may not cover the full cost.Family burden: In addition to managing expenses, family members may need to bring you to appointments, oversee medication, help you with side effects, and take on responsibilities that may overwhelm them.Small increase in survival rate:The increase in survival is often a few weeks or months.Treatment fatigue: Some people feel that continuous interventions prevent them from experiencing any sense of relief that treatment is over or feeling like they are “survivors.”

Other Considerations

While maintenance therapy offers those with inoperable lung cancer some hope, the benefits need to be weighed against some negative factors.Cost: Medications designed for maintenance can be very expensive. Your insurance may not cover the full cost.Family burden: In addition to managing expenses, family members may need to bring you to appointments, oversee medication, help you with side effects, and take on responsibilities that may overwhelm them.Small increase in survival rate:The increase in survival is often a few weeks or months.Treatment fatigue: Some people feel that continuous interventions prevent them from experiencing any sense of relief that treatment is over or feeling like they are “survivors.”

While maintenance therapy offers those with inoperable lung cancer some hope, the benefits need to be weighed against some negative factors.

When to Stop Maintenance Chemo

Depending on factors like the type of cancer and the treatment used, maintenance therapy may last for weeks, months, or even years.

The decision to stop maintenance chemo depends on several variables, such as any side effects you may be experiencing and how they are affecting your quality of life. It is also important to consider how well the cancer is responding to the treatment and other factors like your age and overall health.

Summary

Maintenance therapy for lung cancer is an ongoing treatment typically given after you’ve completed a first-line course of chemotherapy. The goal of maintenance therapy is to keep the cancer in check, improve your quality of life, and help you live longer.

Maintenance therapy works differently for people with different types of cancer, and it can have side effects like fatigue and loss of appetite. If you have lung cancer, talk to your healthcare provider about the benefits and considerations of this type of therapy.

8 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Yoh K, Goto Y, Naito Y, et al.Impact of maintenance therapy for patients with non-small cell lung cancer in a real-world setting.Anticancer Res. 2017;37(3):1507-1514. doi:10.21873/anticanres.11478Feliciano JL, Trosman JR, Weldon CB.Patient self-management and health maintenance at lung cancer diagnosis and during treatment.J Clin Oncol. 2020;38(15 suppl). doi:10.1200/JCO.2020.38.15_suppl.e24036American Cancer Society.Immunotherapy for non-small cell lung cancer.American Cancer Society.Targeted drug therapy for non-small cell lung cancer.Tomasini P, Barlesi F, Mascaux C, Greillier L.Pemetrexed for advanced stage nonsquamous non-small cell lung cancer: latest evidence about its extended use and outcomes.Ther Adv Med Oncol. 2016;8(3):198-208. doi:10.1177/1758834016644155Barton-Burke M, Ciccolini K, Mekas M, Burke S.Dermatologic reactions to targeted therapy: A focus on epidermal growth factor receptor inhibitors and nursing care.Nurs Clin North Am. 2017;52(1):83-113. doi:10.1016/j.cnur.2016.11.005Imfinzi.What should I know before taking Imfinzi?.American Cancer Society.Managing cancer as a chronic illness.

Yoh K, Goto Y, Naito Y, et al.Impact of maintenance therapy for patients with non-small cell lung cancer in a real-world setting.Anticancer Res. 2017;37(3):1507-1514. doi:10.21873/anticanres.11478

Feliciano JL, Trosman JR, Weldon CB.Patient self-management and health maintenance at lung cancer diagnosis and during treatment.J Clin Oncol. 2020;38(15 suppl). doi:10.1200/JCO.2020.38.15_suppl.e24036

American Cancer Society.Immunotherapy for non-small cell lung cancer.

American Cancer Society.Targeted drug therapy for non-small cell lung cancer.

Tomasini P, Barlesi F, Mascaux C, Greillier L.Pemetrexed for advanced stage nonsquamous non-small cell lung cancer: latest evidence about its extended use and outcomes.Ther Adv Med Oncol. 2016;8(3):198-208. doi:10.1177/1758834016644155

Barton-Burke M, Ciccolini K, Mekas M, Burke S.Dermatologic reactions to targeted therapy: A focus on epidermal growth factor receptor inhibitors and nursing care.Nurs Clin North Am. 2017;52(1):83-113. doi:10.1016/j.cnur.2016.11.005

Imfinzi.What should I know before taking Imfinzi?.

American Cancer Society.Managing cancer as a chronic illness.

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