Treatment Name: Cisplatin + Vinblastine + Radiation
How does cisplatin + vinblastine + radiation work?
Cisplatin and vinblastine are chemotherapy drugs designed to kill cancer cells by damaging DNA and preventing lung cancer cells from dividing into new cells. When given with radiation, cisplatin plus vinblastine make the cancer cells more sensitive to the effects of the radiation.
Goals of therapy:
Cisplatin + vinblastine + radiation is given to shrink tumors and improve symptoms of lung cancer. Cisplatin + vinblastine + radiation may be given as first line adjuvant or neoadjuvant therapy with the goal of cure.
Durvalumab (Imfinzi) may be given to certain patients with stage 3 unresectable non-small cell lung cancer (NSCLC) after they complete chemotherapy plus radiation. Durvalumab is given with the goal of preventing the cancer from growing or spreading and the goal of increasing lifespan.
- Cisplatin intravenous (I.V.) infusion over 60 minutes on Days 1 and 29
- Vinblastine I.V. infusion over 5 to 10 minutes on Days 1, 8, 15, 22, and 29
Estimated total infusion time for this treatment:
- Up to 2 hours for Days 1 and 29; as short as 30 minutes for Days 8, 15, and 22
- Infusion times are based on clinical studies, but may vary depending on doctor preference or patient tolerability. Pre-medications and intravenous (I.V.) fluids, such as hydration, may add more time
Cisplatin + vinblastine + radiation is usually given in an outpatient infusion center, allowing the person to go home afterwards.
One course of treatment with cisplatin + vinblastine + radiation is 35 days. This is known as one Cycle and typically only one cycle of treatment is given.
Click here for the common cisplatin + vinblastine + radiation starting doses.
In a multi-drug regimen, each medication has unique side effects. When these medicines are given together, drug-related side effects reported in clinical studies give the best estimate of what to expect. In clinical studies, the most commonly reported serious drug side effects (grade 3 and grade 4) of cisplatin + vinblastine + radiation are shown here:
- Low white blood cells [Neutropenia] (82%)
- Nausea and vomiting (23%)
- Pain and inflammation of throat (23%)
- Low red blood cells [Anemia] (12%)
- Mouth sores (11%)
- Low platelets [Thrombocytopenia] (9%)
- Injury to the lungs (3%)
Typically, most patients complete the planned treatment course and do not have to discontinue treatment due to unacceptable side effects.
How often is monitoring needed?
Labs (blood tests) may be checked before each treatment. Labs often include: Complete Blood Count (CBC), Comprehensive Metabolic Panel (CMP), blood magnesium levels, plus any others your doctor may order.
How often is imaging needed?
Imaging may be checked before treatment, during treatment if there are concerns for side effects, or after the completion of treatment to assess response. Imaging may include: X-rays, magnetic resonance imaging (MRI), computerized tomography (CT) scans, or positron emission tomography (PET) scans.
How might blood test results/imaging affect treatment?
Depending upon the results, your doctor may advise to continue cisplatin + vinblastine + radiation as planned, reduce the dose of future treatments, delay the next dose until the side effect goes away, or switch to an alternative therapy.
- Cisplatin can possibly damage the kidneys. Any damage is usually reversible. Your doctor will monitor your blood for signs of any kidney damage and may give intravenous fluid to help protect your kidneys before or after cisplatin therapy. If you feel dehydrated, tell your doctor
- If you have locally advanced, stage 3 unresectable (cancer that cannot be removed with surgery) non-small cell lung cancer and also complete at least 2 cycles of platinum-containing chemotherapy (medications such as cisplatin or cisplatin) given at the same time as radiation, you may qualify for a medication known as durvalumab (Imfinzi) when chemoradiotherapy is complete. Roughly 25% of patients with non-small cell lung cancer have stage 3 disease at diagnosis and a proportion of these will have unresectable disease.
- A pharmacist should ALWAYS review your medication list to ensure that drug interactions are prevented or managed appropriately
- Clinical trials may exist for NSCLC. Ask your doctor if any studies are currently enrolling in your area. If not, go to clinicaltrials.gov to search for other centers offering study medications
Patient Assistance & Co-payment Coverage
Patients under the age of 65 years, or those with private insurance plans:
If you have insurance and are looking for patient assistance or copay assistance for Cisplatin + Vinblastine + Radiation, we have provided links that may help.
Visit our Patient Assistance page and click the links to various patient assistance programs for help paying for Cisplatin + Vinblastine + Radiation. Depending upon your income, they may be able to help cover the cost of:
For Branded medications (may be available for generic medications too), check with the manufacturer to determine if a co-pay card is offered and if it could reduce your monthly copay.
- If you are uninsured, check with the manufacturer to determine if you are eligible to receive medication at no cost.
Medicare and Medicaid patients (Patients 65 years or older):
The clinic providing treatment will likely pre-authorize medications and immune therapies such as Cisplatin + Vinblastine + Radiation and are the best source to help you understand drug cost.
- Ask to speak with a patient assistance technician or financial counselor at the clinic or hospital administering this therapy.
What is Emotional Wellness?
Emotional wellness is having a positive outlook balanced with a realistic understanding of current life events. This requires both an awareness and acceptance of your emotions. It is with this knowledge that you can develop a plan to take the necessary actions to positively impact your life.
Emotional wellness uses an ongoing process to continually reflect on the stressors of life in a constructive manner to move forward and create happiness.
Because emotional wellness is deeply connected with physical, social, and spiritual wellness, pursuing it often becomes particularly difficult in times of major illness. Despite this difficulty, working toward emotional wellness has been connected to improved treatment outcomes and a higher likelihood of achieving goals of therapy.
Learn more about pursuing emotional wellness while receiving treatment with Cisplatin + Vinblastine + Radiation