Overview of Second-Line Treatment for Cancer

How Is Second-Line Treatment Different From First-Line Cancer Therapy?

picture of chemotherapy IV drip
What is the meaning of second-line treatment for cancer?. Istockphoto.com/tiverylucky

Second-line treatment is treatment for a disease or condition after the initial treatment (first-line treatment) has failed.

Reasons Second-Line Treatment May Be Recommended

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, or
  • The first-line treatment has side effects that are not tolerated.

    Significance of Second-Line Treatment for Cancer

    Since discussing second-line treatment usually means that first-line treatment failed, you are likely feeling a whole host of cancer emotions, similar to when you were first diagnosed. Some people say that it feels like starting all over—but with less energy this time. Usually, first-line treatments are chosen because they have the greatest benefit and/or the fewest side effects. Yet all people are different and respond in different ways to different treatments.

    Second-line treatments are available for most cancers, but the likelihood of effective options can vary with the type and stage of your cancer. In general, the chance of a good result with a second-line treatment is often lower—and is the reason that your and your oncologist began your treatment with a first-line treatment. Still, advances are continually taking place in medicine, and many second-line, and even 3rd-line and 4th-line treatments are improving.

    The Option of Clinical Trials as Second-Line Treatment

    Since any new medications or treatments are first studied in clinical trials, many people may be interested in learning about clinical trials if a first-line treatment has failed (or even before.) 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.

    Learn about the different phases of clinical trials, possible risks, and benefits, and how to find trials that fit your particular circumstances.

    Questions to Ask About Second-Line Treatment

    Since the failure of a first treatment can leave you feeling overwhelmed and anxious, having a list of questions to ask your doctor (as well as a friend to attend the visit with you) can be very helpful.

    • How effective is the second-line treatment, and how does it compare to the treatment you had previously?
    • What are the possible side effects of the treatment?
    • What other options are available for second-line treatment?
    • Would it make a difference to wait before beginning a new treatment?
    • What options lay beyond second-line treatment--3rd-line and 4th-line treatments?
    • Are there any clinical trials that would be appropriate for my particular type and stage of cancer?
    • What is my prognosis if I receive this second-line treatment?

    Also Known As: second-line therapy


    American Society of Clinical Oncology. When the First Treatment Doesn’t Work. 6/2013.