Non-Small Cell Lung Cancer Treatment (PDQ®)—Patient Version - National Cancer Institute

Non-Small Cell Lung Cancer Treatment (PDQ®)–Patient Version

Treatment Options by Stage

For information about the treatments listed below, see the Treatment Option Overviewsection.

Occult Non-Small Cell Lung Cancer

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.

Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

Stage 0

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.

Stage I Non-Small Cell Lung Cancer

Treatment of stage IA non-small cell lung cancer and stage IB non-small cell lung cancermay 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.
A 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.

Stage II Non-Small Cell Lung Cancer

Treatment of stage IIA non-small cell lung cancer and stage IIB non-small cell lung cancermay 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.

Stage IIIA Non-Small Cell Lung Cancer

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.

For more information about supportive care for signs and symptoms including cough, shortness of breath, and chest pain, see the PDQ summary on Cardiopulmonary Syndromes.

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.

Stage IIIB and Stage IIIC Non-Small Cell Lung Cancer

Treatment of stage IIIB non-small cell lung cancer and stage IIIC non-small cell lung cancermay 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.

For more information about supportive care for signs and symptoms such as cough, shortness of breath, and chest pain, see the following PDQ summaries:

Newly Diagnosed Stage IV, Relapsed, and Recurrent Non-Small Cell Lung Cancer

Treatment of newly diagnosed stage IV, relapsed, and recurrent non-small cell lung cancermay include the following:

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 therapyto help keep cancer from progressing.
Targeted therapy with an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, such as osimertinib, gefitinib, erlotinib, or afatinib.
Targeted therapy with an anaplastic lymphoma kinase (ALK) inhibitor, such as alectinib, crizotinib or ceritinib.
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.
A clinical trial of new drugs and combinations of treatments.

Progressive Stage IV, Relapsed, and Recurrent Non-Small Cell Lung Cancer

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.

To Learn More About Non-Small Cell Lung Cancer

For more information from the National Cancer Institute about non-small cell lung cancer, see the following:

Lung Cancer Home Page
Lung Cancer Prevention
Lung Cancer Screening
Drugs Approved for Non-Small Cell Lung Cancer
Targeted Cancer Therapies
Lasers in Cancer Treatment
Photodynamic Therapy for Cancer
Cryosurgery in Cancer Treatment
Tobacco (includes help with quitting)
Secondhand Smoke and Cancer

For general cancer information and other resources from the National Cancer Institute, see the following:

About This PDQ Summary

About PDQ

Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.

PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.

Purpose of This Summary

This PDQ cancer information summary has current information about the treatment of non-small cell lung cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.

Reviewers and Updates

Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Updated") is the date of the most recent change.

The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board.

Clinical Trial Information

A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

Clinical trials can be found online at NCI's website. For more information, call the Cancer Information Service (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237).

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The best way to cite this PDQ summary is:

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

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