Treatments for non-small cell lung cancer

Treatment for non-small cell lung cancer (NSCLC) depends mainly on the stage of the cancer (how far it has spread), the type of non-small cell lung cancer (adenocarcinoma or squamous cell carcinoma), the presence of biomarkers (either genetic changes or markers of cancer detected by immunohistochemistry), and a person’s general health and their wishes and treatment goals. It may include several different types of treatment, either on their own or in combination.

Treatment for early-stage non-small cell lung cancer may aim to cure the cancer. For more advanced stages, treatment usually aims to control the cancer, relieve symptoms, and prolong life, rather than cure the disease.

Most treatments are systemic, meaning they travel through the bloodstream to reach cancer cells throughout the body. Each treatment can cause side effects, which your care team will discuss with you.

Surgery

Surgery is most often used for early-stage non-small cell lung cancer, but in some cases, it may also be an option for patients with more advanced disease. For example, surgery, often in combination with chemotherapy, immunotherapy, or radiotherapy, may be considered when the tumor has spread to nearby areas but can still be removed safely.

Depending on the size of the tumor, surgery may involve removing:

The tumor and a small amount of surrounding tissue (wedge resection).
The affected part (lobe) of a lung (a lobectomy).
An entire lung (pneumonectomy).

Surgery may be combined with treatments given before (neoadjuvant) or afterwards (adjuvant), such as chemotherapy, targeted therapies, immunotherapy, and/or radiotherapy.

Radiotherapy

Radiotherapy uses high-energy radiation to destroy cancer cells. It may be used instead of surgery or alongside other treatments. A specialized form called stereotactic body radiotherapy (SBRT) can target the chest or specific areas where cancer has spread. Radiotherapy may also be used to relieve symptoms.

Chemotherapy

Chemotherapy uses medicines that kill rapidly dividing cancer cells. It can be given alone or with surgery, radiotherapy, immunotherapy, or targeted therapy. Platinum-based chemotherapy is commonly used, usually combined with another medicine, such as:

Docetaxel.
Gemcitabine.
Paclitaxel.
Pemetrexed.
Vinorelbine.

Immunotherapy

Immunotherapy helps the immune system recognize and attack cancer cells. Many lung cancer cells produce a protein called PD-L1, which binds to the PD-1 receptor on T cells (a type of immune cell) and can turn off immune cells, so cancer cells avoid being destroyed.

Immune checkpoint inhibitors – the main immunotherapy drugs used for non-small cell lung cancer – block this process and help the immune system destroy the cancer cells. Examples include pembrolizumab, nivolumab, atezolizumab, and durvalumab.

Biomarker testing, including measuring PD-L1 levels, can help determine whether immunotherapy is likely to be effective. Immunotherapy may be given before or after surgery, alone or with chemotherapy, or after chemoradiotherapy for certain patients with Stage 3 non-small cell lung cancer.

Each of these medicines has slightly different uses and may be recommended depending on your specific situation. Not all patients can have immunotherapy, especially if they have certain autoimmune conditions.

Targeted therapy

Targeted therapies act on cancer cells with specific gene changes. These treatments only work if the tumor has the right biomarker. Examples include:

ALK (alectinib, brigatinib, ceritinib, crizotinib, lorlatinib).
BRAF V600 (dabrafenib + trametinib combination, encorafenib + binimetinib combination).
EGFR (afatinib, amivantamab, dacomitinib, erlotinib, gefitinib, lazertinib, osimertinib).
EGFR exon 20 insertions (amivantamab, sunvozertinib).
HER2 (sevabertinib, trastuzumab deruxtecan, zongertinib).
KRAS (adagrasib, sotorasib).
MET (capmatinib, tepotinib).
NTRK (entrectinib, larotrectinib).
RET (selpercatinib).
ROS1 (crizotinib, entrectinib, repotrectinib, taletrectinib).

Your healthcare team will check if your cancer has any of these changes.

Nintedanib, a multikinase inhibitor, is commonly used in combination with a chemotherapy drug called docetaxel in patients with previously treated advanced adenocarcinoma.

Treatment for relapse or recurrence

If non-small cell lung cancer returns after treatment (relapsed or recurrent non-small cell lung cancer), or does not respond, further treatment options may include chemotherapy, immunotherapy, and targeted therapy. The choice depends on how far the cancer has spread, previous treatments, and a person’s overall health.

Supportive care

Supportive care focuses on managing symptoms and maintaining quality of life, and this can be given alongside active treatment or on its own if further treatment is not suitable. It may include pain relief, radiotherapy to specific areas to reduce symptoms, procedures to keep airways open, and support from palliative care teams.

Clinical trials

Clinical trials test new treatments or new ways of using existing treatments. They may offer access to promising therapies being studied for non-small cell lung cancer that are not yet widely available. Your healthcare team can help determine if a clinical trial may be suitable for you.

Participating in a clinical trial can also enable access to expert care and additional monitoring, and it gives the opportunity to contribute to research that may help future patients.

References

National Cancer Institute. Non-small cell lung cancer treatment (PDQ®)–patient version. https://www.cancer.gov/types/lung/patient/non-small-cell-lung-treatment-pdq. Updated May 16, 2025. Accessed Mar 4, 2026.
Cancer Research UK. Treatment options for non small cell lung cancer (NSCLC). https://www.cancerresearchuk.org/about-cancer/lung-cancer/treatment/non-small-cell-lung-cancer. Updated Jan 14, 2026. Accessed Mar 4, 2026.
Cancer Research UK. Chemotherapy for lung cancer. https://www.cancerresearchuk.org/about-cancer/lung-cancer/treatment/chemotherapy-treatment. Updated Jan 14, 2026. Accessed Mar 4, 2026.
Cancer Research UK. Targeted and immunotherapy treatment for lung cancer. https://www.cancerresearchuk.org/about-cancer/lung-cancer/treatment/immunotherapy-targeted. Updated Jan 14, 2026. Accessed Mar 4, 2026.