Overview of Second-Line Treatment for Cancer

close up of an IV drip


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


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 you 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

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

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 your particular type and stage of cancer?
  • What is your prognosis if you receive this second-line treatment?
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