Treatment given after the failure of standard or prior therapies.
- It is usually considered when the cancer is refractory (not responding) or has relapsed (returned) after first-line or subsequent lines of treatment.
- Salvage therapy may involve chemotherapy, targeted therapy, immunotherapy, radiotherapy, surgery, or stem cell transplant, depending on the cancer type and prior treatments.
Key Points for Oncology Pharmacists:
- Purpose: To achieve disease control, prolong survival, or provide symptom relief when curative options are limited.
- Examples:
- Salvage chemotherapy in relapsed lymphoma (e.g., ICE, DHAP, GDP regimens).
- Salvage surgery after chemoradiation failure in head and neck cancer.
- Salvage stem cell transplantation in relapsed multiple myeloma or lymphoma.
- Pharmacist’s role:
- Optimize drug selection based on prior exposure, resistance patterns, and patient comorbidities.
- Manage cumulative toxicities (e.g., anthracycline cardiotoxicity, neuropathy from taxanes/platinums).
- Evaluate clinical trial eligibility for novel salvage regimens.
In short: “Salvage” = a last-chance or rescue treatment approach after failure of standard therapies.