Last reviewed 2026-04-23 · How we verify

Second-Line Chemotherapy

Second-line chemotherapy refers to cytotoxic drug regimens administered after first-line treatment failure or progression in cancer patients.

Second-line chemotherapy refers to cytotoxic drug regimens administered after first-line treatment failure or progression in cancer patients. Used for Advanced or metastatic cancers after first-line chemotherapy failure or progression.

At a glance

Mechanism of action

Second-line chemotherapy encompasses various chemotherapeutic agents (often platinum-based, taxanes, or other cytotoxics) used sequentially when initial chemotherapy regimens have failed or the cancer has progressed. The specific mechanism depends on the individual drugs used, but generally involves DNA damage, microtubule disruption, or other cell-cycle targeting mechanisms to eliminate rapidly dividing cancer cells.

Approved indications

• Advanced or metastatic cancers after first-line chemotherapy failure or progression

Common side effects

• Myelosuppression (neutropenia, anemia, thrombocytopenia)
• Nausea and vomiting
• Peripheral neuropathy
• Alopecia
• Mucositis
• Fatigue

Key clinical trials

• A Study to Evaluate the Efficacy and Safety of Sacituzumab Tirumotecan (MK-2870) Maintenance Treatment Versus Standard of Care in Participants With Platinum-sensitive Recurrent Ovarian Cancer (MK-2870-022/TroFuse-022/ENGOT-ov84/GOG-3103) (PHASE3)
• Studying Chemotherapy With or Without Panitumumab for Unresectable, Locally Advanced, or Metastatic Pancreatic Cancer Without KRAS Mutations (PHASE3)
• A Study of NX-5948 in Adults With Relapsed/Refractory B-cell Malignancies (PHASE1)
• Study of Chemotherapy, With or Without Binimetinib in Advanced Biliary Tract Cancers in 2nd Line Setting (A ComboMATCH Treatment Trial) (PHASE2)
• HAIC Plus Systemic Therapy as De-escalation Therapy Strategy for Biliary Tract Cancer (NA)
• Immunotherapy Biomarkers to Predict First-line PD(L)1-based Immunotherapy Response and Selection of Second-line Treatment in Stage IIIB-IV Non-small Cell Lung Cancer, IMMUNO-BIOMAP Trial (PHASE2)
• Testing the Use of Investigational Drugs Atezolizumab and/or Bevacizumab With or Without Standard Chemotherapy in the Second-Line Treatment of Advanced-Stage Head and Neck Cancers (PHASE2, PHASE3)
• L-Annamycin for Injection in Combination With Cytarabine Injection as Second Line Therapy for Remission Induction in Adult Subjects With Refractory/Relapsed AML (PHASE2, PHASE3)

Primary sources

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