what is a second line treatment

Second-Line Treatment for Chronic Lymphocytic Leukemia

• Chemotherapy. This treatment uses strong drugs to kill cancer cells all over your body. ...
• Monoclonal antibodies. Antibodies are immune system proteins that help your body find and kill cancer cells. ...
• Targeted drugs. ...
• Stem cell transplant. ...
• Treating minimal residual disease. ...
• Clinical trials. ...
• Takeaway. ...

Full Answer

What is “second-line treatment”?

A break with the primary treatment and an adoption of a new regimen signals “second-line treatment.” The first-line therapy may not have worked, may have had some limited efficacy, or may have produced unacceptable side effects, damaged organs in the body, or jeopardized the patient’s life.

What is the second line of treatment for cancer?

Overview of Second-Line Treatment for Cancer. Second-line treatment is treatment for a disease or condition after the initial treatment ( first-line treatment) has failed. Second-line treatment may be used for a few different reasons: The first-line treatment doesn't work The first-line treatment worked but has since stopped working.

What makes a drug second-line?

What makes a drug second-line? These are your medicines that are less commonly prescribed for a particular disease. But, they are available as options when first-line treatments alone are not working. What classifies a medicine as the second line?

What is the difference between first line and second line therapy?

For example, one clinical trial may require the treatment to be used as a first line therapy, whereas another may only be entered if a person has "failed" first line or second line treatment. For those who are considering second line treatments, the option of clinical trials should be considered.

What is second line treatment?

Why do we use second line therapy?

What is the importance of defining lines of treatment?

Why is understanding the line of treatment important?

Is first line treatment more effective than present treatment?

Is second line therapy better than first line?

Is breast cancer a first line treatment?

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What is the difference between first line and second line drugs?

Your first-line treatment may not work, may start but then stop working, or may cause serious side effects. Your doctor may then suggest a second-line treatment, also called second-line therapy. It is a different treatment that is likely to be effective.

What is first line and second line?

At the core of any IT service desk is first line and second line. These are the levels that cover most issues raised by your user community, with the highest ticket volumes for IT related problems.

What is 3rd line treatment?

Treatment that is given when both initial treatment (first-line therapy) and subsequent treatment (second-line therapy) don't work, or stop working.

What does line of treatment mean?

The first treatment given for a disease. It is often part of a standard set of treatments, such as surgery followed by chemotherapy and radiation.

What is second line antibiotics?

Antibiotics were classified as “first-line” (amoxicillin, TMP-SMX, or erythromycin) or “second-line” (clarithromycin, azithromycin, amoxicillin-clavulanate, cephalosporin, or fluoroquinolone).

What is the difference between 2nd line and 3rd line support?

Second Line Support: A team with more technical knowhow who can assist with more complex issues. Third Line Support: A third-party expert technician who understands the problem well enough to diagnose it and provide solutions for fixing it.

What is first line chemo?

The standard first-line chemotherapy for all patients is bleomycin, etoposide, and cisplatin (BEP) using a 5-day schedule. 53,96. Modifications in BEP, such as substitution of cisplatin with carboplatin to reduce toxicity or improve convenience, should be avoided because they may reduce efficacy.

What is palliative chemotherapy?

Clarification regarding the term palliative chemotherapy is critical: palliative chemotherapy is defined as chemotherapy that is given in the non-curative setting to optimize symptom control, improve quality of life (QoL) and, ideally, to improve survival.

How effective is third line chemotherapy?

The median survival was 23 months (95% CI, 20.9–25.1) in patients treated with more than third-line chemotherapy, compared to 7 months (95% CI, 4.7–9.3) in patients treated with less than second-line chemotherapy (Fig.

What happens after 2nd chemo treatment?

Nausea, vomiting, and taste changes You may experience nausea (feeling like you might throw up) and vomiting (throwing up) after your last chemotherapy treatment. It should go away in 2 to 3 weeks. Your appetite may continue to be affected due to taste changes you may have experienced during your treatment.

Is chemo worse the second time around?

The effects of chemo are cumulative. They get worse with each cycle. My doctors warned me: Each infusion will get harder. Each cycle, expect to feel weaker.

How many rounds of chemo is normal?

During a course of treatment, you usually have around 4 to 8 cycles of treatment. A cycle is the time between one round of treatment until the start of the next. After each round of treatment you have a break, to allow your body to recover.

Anyone have success with a second-line treatment - Inspire

Hello Everyone, My partner was disgnosed with 3c advanced cancer in May 2021, since then she as had 6 rounds of chemo & frontline surgery to remove the cancer which was successful, her latest pet scan came back clear, which is great news.

2nd line treatment - Bowel Cancer UK

Hi there I wonder if you could help me understand a few things. I did ask my oncologist but didn't really take in her answers. I was diagnosed in Jan 2014 with primary bowel cancer, described as "barely discernible" and multiple mets to the liver.

2nd line chemo for ovarian cancer - Chemotherapy - MedHelp

Hi, If ovarian cancer recurrence is within one year of a platinum based chemotherapy, (and especially if it occurs within 6 months), it is more likely to be resistant to subsequent platinum chemotherapy. Using cancer biology models, scientists have shown that chemotherapy is more effective when the number of cancer cells (disease burden) is lower.

Clinical Challenges: Second-Line Treatment for NSCLC After Failure of ...

"For patients that achieve a good response, we can consider continuation of immunotherapy through multiple lines of therapy, and this is currently being tested in clinical trials," Stevenson said ...

What is the best second line therapy for SCLC?

There is no best salvage regimen or drug for recurrent or resistant SCLC. 689 Topotecan is the only agent approved by the FDA for use as second-line chemotherapy in SCLC.690,691 It is associated with a modest prolongation of survival and quality-of-life benefit whether given intravenously or orally. 692 Other agents such as paclitaxel, 693,694 oral etoposide, 695 irinotecan, 696 amrubicin, 697 and temozolomide 698 are also useful in this setting. From a practical standpoint, the most important factors influencing the decision to administer second-line therapy are the patient's current PS, the level of sensitivity to induction therapy, and the interval since prior therapy. Patients with a good PS, sensitivity to prior therapy, and a progression-free period of more than 3 months are much more likely to respond to second-line treatment. Retreatment with the induction regimen or one of the aforementioned agents is appropriate for patients meeting these criteria. For all others, second-line therapy tends to be a process of trial and error with single agents or combinations. 689 Paclitaxel-containing regimens may be especially useful in patients without prior response or a very short treatment-free interval after initial first-line treatment, especially if nonplatinum therapy is employed as induction therapy. 693,694 RT can be an effective treatment for palliation of specific symptoms and isolated intrathoracic relapses. 689

Why is second line chemo important?

Because disease relapse is usually incurable, the principal aim is to prolong symptom-free survival and palliate symptoms. The benefit of second-line chemo is dependent on the disease-free interval from completion of treatment to relapse.

What is autologous SCT?

Autologous SCT was evaluated in patients with refractory or relapsing PTCL, chemosensitive to second-line chemotherapy, excluding patients with indolent histologies and those with anaplastic lymphoma kinase (ALK) expressing anaplastic large cell lymphoma. The results of 24 patients with PTCL were compared with those of 86 consecutive patients with chemosensitive relapsed or primary refractory diffuse large B-cell lymphoma (DLBCL). With a median follow-up time of 6 years for surviving patients with PTCL and DLBCL, the 5-year PFS rates for PTCL and DLBCL patients were 24% and 34%, respectively, and 33% and 39% overall survival rates were not significantly different. The age-adjusted IPI was the only variable prognostic for PFS and OS on multivariate analysis. The authors concluded that the outcome of SCT for patients with chemosensitive relapsed or primary refractory PTCL is similar to that seen in patients with DLBCL.54

Does second line chemotherapy affect survival?

Second line chemotherapy could have an impact on overall survival of mesothelioma patients, as already shown by Manegold and colleagues in the retrospective analysis of patients from the phase III study by Vogelzang in 2003.

Can platinum be used for IV?

Platinum responders who relapsed after a disease-free interval of six months may also be retreated by IV platinum regimens. Carboplatin is the preferred platinum compound for IV treatment since it is as active as cisplatin but significantly less nephrotoxic, neurotoxic, and ototoxic.

Is there a survival benefit for second line chemo?

Until recently, there were no large randomized studies to support a survival benefit for second-line chemotherapy in EGCs. There are now three randomized studies performed in patients with gastric cancer to support such a benefit.

Is paclitaxel a second line chemo?

Only a few other agents (in particular, paclitaxel, CPT-11, carboplatin, etoposide plus cisplatin) have been investigated for second-line chemotherapy in patients with AOD. Except for the small numbers investigated with cisplatin and etoposide, with 4 of 10 patients responding, the response rates are low (in the 10–15% range), with one-third of patients free from progression at 6 months and virtually all patients progressing at 12 months. A drawback of some of these agents (paclitaxel, CPT-11) is their metabolism through the cytochrome CYP3A4and UGT-1A1, which implies that their metabolism may have been induced by enzyme-inducing antiepileptic agents. This enzyme induction limits the role of these and other cytotoxic agents metabolized through the CYP 3A4 and other metabolic pathways in patients receiving concomitant medication that induce or inhibit metabolism of the antineoplastic agent administered, and may also have affected the observed activity in the above-mentioned trials. One trial of PCV chemotherapy followed by an autologous bone marrow transplantation after a myeloablative procedure with melphalan proved too toxic, without clearly producing superior results. Despite the upregulation of platelet-derived growth factor (PDGF) signaling pathways in most oligodendrogliomas, the PDGF receptor tyrosine kinase inhibitor imatinib did not show any activity in recurrent oligodendroglioma or AOD/AOA (Raymond et al., 2008 ).

What is second line therapy?

Second-line therapies are those tried when the first ones do not work adequately. The management of a cancer case requires regular evaluation of treatment and adjustment as needed. A break with the primary treatment and an adoption of a new regimen signals “second-line treatment.”.

What is the first line of treatment?

First line therapy is the treatment regimen or regimens that are generally accepted by the medical establishment for initial treatment of a given type and stage of cancer. It is also called primary treatment or therapy. The intent of first-line therapy is to cure the cancer if possible. Also called induction therapy, this primary therapy is the first assault of chemotherapy drugs on the malignancy.

What is the intent of first line therapy?

The intent of first-line therapy is to cure the cancer if possible. Also called induction therapy, this primary therapy is the first assault of chemotherapy drugs on the malignancy.

Is salvage therapy considered third line therapy?

The terms “third-line therapy ” and even “fourth-line therapy” are occasionally used for subsequent treatment, but salvage therapy is also used. Written guidelines rarely specify anything beyond second-line therapy. The same treatments can be used for subsequent treatment.

Can a first line therapy be approved for second line therapy?

Sometimes first-line therapies show progress for a period of time followed by a stalling or continued growth of the cancer. Often the FDA will specifically approve a new drug for second-line therapy. This labeling is common for new drugs that treat cancers which already have accepted treatments.

Is there a law on first line therapy?

There is no law, or even a community of practice rule, that doctors must use the accepted first-line therapy for a patient, ...

Is there a law that states that doctors must use first line therapy?

There is no law, or even a community of practice rule, that doctors must use the accepted first-line therapy for a patient, although when they do they “cover their backsides” to some extent and reduce their exposure to malpractice suits. Second-line therapies are those tried when the first ones do not work adequately.

What makes a drug first line?

What makes a drug first-line? These are the medicines doctors first resort to for a given disease (the doctors first choice try). They are the most commonly prescribed medicines for a particular disease. These medicines are well accepted by the medical community. For asthma, they include systemic corticosteroids like Flovent, Asmanex, and Qvar.

Is corticosteroids a first line treatment for COPD?

So, it remains a first-line treatment for COPD. Likewise, because it may help some asthmatics, it remains a second-line option here. Researchers learn more. Back in the 1970s, doctors were leary that inhaled corticosteroids (ICS) may cause the same side effects as systemic corticosteroids.

Is Atrovent a first line asthma medicine?

Atrovent was once-upon-a-time considered a first-line asthma medicine. It fit all the qualifications of one. But, subsequent studies did not show it benefited most asthmatics. Studies do show, however, that it does help most COPDers. So, it remains a first-line treatment for COPD.

What is a second line drug?

second-line drug. Any therapeutic agent that is not the drug of choice, or the 1 st normally used to treat a particular condition ; in rheumatoid arthritis, 2 nd-line agents are used when standard 'first-line' therapy–ie, anti-inflammatory agents and corticosteroids fail.

How many people need a second line drug?

More than half of patients nationwide (60 per cent) who need a second-line drug are prescribed one of these two drugs, the study found. Drugs prescribed for type 2 diabetes linked to higher risk of heart disease. Although the patient with recurrent glioblastoma has multiple choices of therapy, the 5-year survival rate is still less than 5%, ...

Is Duo Cotexcin a second line drug?

The head of the National Malaria Control Programme, Dr Waqo Ejersa, said the prescribed drug was only limited to a particular batch that failed to meet quality specifications as laid-down in the ministry and World Health Organization guidelines."Duo-Cotexcin is normally used as a second-line drug in the treatment of malaria in the country.

What is the first line of therapy?

You know, the first line of therapy is just the first treatment that you end up getting. Now, traditionally, again, that’s been the best treatment that we’ve had, the ones that have had the most effectiveness in terms of shrinking cancer cells and in terms of improving survival.

Is a second line better than a third line?

So that second line is just the second treatment you get. There are lines in the third treatment that you get. But, of course, there are patients who get second-line and third-line treatments that are better than their first-line treatments sometimes. A great example of this would be targeted therapy where, a patient may not have time ...

What is second line treatment?

Second-line treatment is treatment for a disease or condition after the initial treatment ( first-line treatment) has failed, stopped working, or has side effects that aren't tolerated. It's important to understand "lines of treatment" and how they differ from first line treatment and can play a role in clinical trials.

Why do we use second line therapy?

Second-line or further lines of therapy (third-line, fourth-line, seventh-line, etc.) may be used for a few different reasons: The first-line treatment worked but has since stopped working. The first-line treatment has side effects that are not tolerated.

What is the importance of defining lines of treatment?

An example of the importance of defining lines of treatment is a 2019 study that compared different second-line treatments for lung cancer. Since there are a number of different options, and many studies look at the effectiveness of first line therapies, this can give important information to oncologists.

Why is understanding the line of treatment important?

Understanding line of treatment becomes very important when looking at clinical trials for cancer. Some clinical trials require that people have no previous treatments, whereas others are designed for people who have had inadequate results with a previous treatment.

Is first line treatment more effective than present treatment?

The first-line treatment has side effects that are not tolerated. A new treatment becomes available that appears to be more effective than the present treatment. With survival rates improving for many cancers, and the number of available treatments increase, some people receive many lines of therapy.

Is second line therapy better than first line?

In some cases a person will have a better response to a second line therapy than they did to first line treatment. Second-line treatments are available for most cancers, but the likelihood of effective options can vary with the type and stage of your cancer.

Is breast cancer a first line treatment?

First line treatment can include more than one treatment method. For example, if a woman has surgery followed by chemotherapy and radiation for breast cancer, the combination of therapies is still considered first line therapy.

Lines of Treatment

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The Option of Clinical Trials

Questions to Ask About Second-Line Treatments

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Coping