Cancer Treatment Centers of America
Laurence Altshuler, MD,

Chemotherapy not working? What can you do?


It is well known that the chemotherapies recommended for various cancers may not work or may not work for very long. As a result, many patients and physicians look for anything that may have a benefit and turn to drugs that have not been approved for a particular cancer, which is called “off-label” use. The question is: Can using off-label chemotherapies help you?

A study published in the February issue of Journal of Clinical Oncology found that using off-label chemotherapies is common. About one-third of chemotherapies are used to fight cancers that the FDA never approved them to treat. Off-label chemotherapy use, though, may jeopardize patient safety due to unknown risks. In addition, these drugs are very expensive. If they don’t work, a lot of money and time is wasted.

It should be noted that experts have supported the use of some off-label chemotherapy even without FDA approval. The study showed that experts supported 14 percent of chemotherapies prescribed off-label. The National Comprehensive Care Network (NCCN) or FDA did not approve of 10 percent of off-label chemotherapies.  Most oncologists follow NCCN guidelines but some researchers have criticized NCCN recommendations because of possible delays in incorporating the latest data into the guidelines.

So that brings us back to the original question: Can off-label chemotherapies help cancer patients? Unfortunately, the authors found no studies that have measured the results. All we have are personal accounts from oncologists, many who have seen the benefit of using chemotherapies off-label.

It is ultimately up to you, the cancer patient, to decide whether to use off-label chemotherapies. If your oncologist recommends them, you need to discuss it fully and ask pertinent questions regarding why your oncologist thinks it will help, what other similar patients have experienced and if the benefits are most likely to be greater than the side effects. If there is hope that off-label chemotherapies will work, they may be worthwhile. But remember it may be a burden on your pocketbook.

Finally, I highly recommend getting a second opinion from another oncologist. There may be other options available that may help as much or even more.