Systemic therapy is one of the main approaches used to treat lung cancer, working throughout the body to target cancer cells wherever they may be. It includes treatments such as chemotherapy, targeted therapy, and immunotherapy — each playing a crucial role depending on the type and stage of the disease. For patients in London and across the UK, access to modern systemic treatments has transformed the outlook of lung cancer, improving both survival and quality of life.
Dr Dionysis Papadatos-Pastos, consultant medical oncologist specialising in thoracic malignancies, explains what patients need to know.
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Topics CoveredWhat Is Systemic Therapy?
Unlike surgery or radiotherapy, which act locally, systemic therapy travels through the bloodstream, reaching cancer cells that may have spread beyond the lungs.
It is often used:
- Before and / or after surgery
- In combination with radiotherapy or after radiotherapy
- Or to control advanced disease, prolong life and relieve symptoms.
Systemic therapy can be used alone or in combination with other treatments such as radiotherapy and surgery, depending on the stage and biology of the tumour.
Chemotherapy: The Traditional Foundation of Systemic Treatment
Chemotherapy remains one of the cornerstones of lung cancer treatment. It works by attacking rapidly dividing cells, including cancer cells.
While it can cause side effects such as fatigue, nausea, and temporary hair loss, modern anti-nausea medication and supportive care have made it far more tolerable than in the past.
Chemotherapy may be recommended for:
- Patients with advanced or metastatic disease,
- Those with small cell lung cancer (SCLC),
- Or in combination with radiotherapy for locally advanced tumours.
In many cases, chemotherapy is combined with newer forms of systemic therapy for enhanced effect.
Targeted Therapy: Personalised Precision Treatment
Targeted therapy is designed for patients whose tumours carry specific genetic mutations or molecular alterations — such as EGFR, ALK, or ROS1.
Instead of attacking all rapidly dividing cells, targeted therapy focuses only on cancer cells driven by those mutations.
This precision approach has dramatically improved outcomes for many patients with non-small cell lung cancer (NSCLC).
A simple tissue or liquid biopsy can reveal whether a patient is eligible for a targeted agent, often taken orally as a tablet.
In London, comprehensive molecular testing is now standard practice before initiating treatment, ensuring that every patient receives the most appropriate, personalised care.
Immunotherapy: Harnessing the Immune System
In recent years, immunotherapy has revolutionised the treatment of lung cancer.
It works by stimulating the patient’s own immune system to recognise and attack cancer cells — something that cancer often suppresses to evade detection.
Immunotherapy is now a standard first-line treatment in many cases of NSCLC and is sometimes combined with chemotherapy for greater benefit.
While side effects are generally milder than chemotherapy, immune-related reactions can occasionally occur and require careful monitoring by an experienced oncologist.
Dr Papadatos-Pastos has extensive experience in using immune checkpoint inhibitors, helping patients manage side effects safely while maximising therapeutic benefit.
Combining Systemic and Local Treatments
Modern lung cancer care is often multimodal — combining systemic therapy with surgery or radiotherapy for better long-term control.
For example:
- Chemotherapy or immunotherapy before surgery (neoadjuvant therapy) can shrink tumours,
- Post-operative systemic treatment (adjuvant therapy) can help prevent recurrence,
- And radiotherapy can be added for local disease control.
This integrated approach is coordinated by a multidisciplinary team (MDT) including oncologists, surgeons, radiologists, and respiratory specialists — a key part of cancer care in leading London hospitals.
Managing Side Effects and Supporting Quality of Life
Systemic therapy can cause side effects, but early recognition and supportive interventions make a major difference.
Patients are encouraged to report symptoms such as fatigue, appetite loss, rash, or shortness of breath.
Supportive treatments — antiemetics, growth factors, dietary adjustments, and psychological care — are all part of comprehensive cancer management.
Modern oncology prioritises both survival and wellbeing, helping patients maintain as much normality as possible throughout treatment.
The Future of Systemic Therapy for Lung Cancer
The future of systemic therapy is shaped by ongoing research into:
- Combination strategies (e.g., immunotherapy + targeted therapy)
- Biomarker-driven treatments
- Personalised dosing and adaptive protocols
Clinical trials in London continue to expand access to these next-generation therapies, allowing patients to benefit from medical advances earlier than ever before.
Support and Follow-Up Care
Dr Papadatos-Pastos and his team provide ongoing support beyond medical treatment.
Patients receive clear communication, psychological care and access to nutrition, physiotherapy and symptom-management services.
Regular follow-up ensures early detection of recurrence and long-term wellbeing.
Book a Consultation
If you or someone close to you has been diagnosed with lung cancer, early consultation with a specialist can make a real difference. Appointments are available at several London clinics.
Faq
Answers to Common Questions
Systemic therapy can sound complex, especially with so many new treatment options available today. Here are answers to some of the most common questions patients ask about chemotherapy, targeted therapy and immunotherapy for lung cancer.
No. Chemotherapy is one form of systemic therapy. The term “systemic therapy” also includes targeted therapy and immunotherapy — all of which act throughout the body.
Treatment duration varies depending on the type of drug and response to therapy. Some patients receive cycles over a few months, while others continue maintenance immunotherapy for up to two years.
Yes. Many patients benefit from a combination approach — for example, receiving systemic therapy before or after surgery to improve long-term outcomes.
Fatigue, nausea, appetite loss, and mild changes in blood counts are common. Most can be managed effectively with supportive medication and monitoring from your oncology team.
In most cases, systemic therapy helps control or shrink lung cancer rather than cure it completely. However, for some patients — especially those with early-stage disease or strong response to targeted or immunotherapy — long-term remission is possible.
