Induction chemotherapy is the initial phase of cancer treatment that aims to destroy as many cancer cells as possible. A person may receive induction chemotherapy before maintenance chemotherapy, radiation therapy, or surgery.

Induction chemotherapy is an intensive cancer treatment that can improve survival rates for certain types of cancer. However, the treatment has links to certain risks and side effects and may not be suitable for everyone.

This article explores induction chemotherapy in more detail and lists the different types of cancer it can help treat. We also describe the potential benefits and risks of induction chemotherapy.

Learn more about chemotherapy here.

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Induction therapy refers to the first-line treatment for a particular disease. The National Cancer Institute refers to it as first-line therapy, primary therapy, or primary treatment.

Induction chemotherapy is the initial chemotherapy a person receives before undergoing additional cancer treatment, such as maintenance chemotherapy, radiation therapy, or surgery. The goal of induction chemotherapy is to destroy as many cancer cells as possible to offer the best possible chance of disease remission.

The length and intensity of induction therapy may vary, depending on several factors, including:

  • the cancer type and severity
  • the person’s age
  • the person’s overall health

Induction treatment may be an appropriate treatment option for people who have cancer with a high risk of spreading.

Doctors may recommend induction chemotherapy for various cancers, including:

Below are some potential benefits of induction chemotherapy according to cancer type.

Acute myeloid leukemia

Acute myeloid leukemia (AML) is an aggressive form of leukemia that affects white blood cells. The American Cancer Society (ACS) states that induction chemotherapy is the first of two treatment phases for AML, with the second phase being consolidation or “post-remission therapy.”

The goal of induction therapy in AML is to destroy as many leukemia cells as possible. However, the intensity of the treatment depends on the person’s age and overall health.

For example, doctors may suggest an intensive chemotherapy treatment for people below the age of 60 years. This treatment typically involves the chemotherapy agents cytarabine and daunorubicin or idarubicin.

Daunorubicin and idarubicin belong to a class of chemotherapy drugs called anthracyclines, which derive from certain strains of bacteria. These drugs may be unsafe for people with heart problems. If a person has an underlying heart condition, their doctor may recommend a different chemotherapy drug, such as fludarabine or etoposide.

Learn more about AML treatment here.

Head and neck cancers

A 2019 study suggests that people with certain types of head and neck cancers may benefit from induction chemotherapy involving a combination of the following chemotherapy agents:

  • docetaxel
  • cisplatin
  • fluorouracil

The researchers also note that inductive chemotherapy with this combination of chemotherapies has similar results in comparison with inductive chemotherapy and radiation therapy. However, the evidence is inconclusive, so researchers cannot make any definite recommendations.

Learn more about head and neck cancer here.

Esophageal cancer

A 2016 review article notes that induction chemotherapy and removing part or all of the esophagus may improve outcomes in individuals with locally advanced esophageal tumors that surgeons cannot remove.

Learn more about esophageal cancer here.

Nasopharyngeal carcinoma

Nasopharyngeal carcinoma refers to cancers of the nasopharynx. This is the area at the top of the throat, behind the nose, and above the roof of the mouth.

A 2019 clinical trial found that a combination of induction chemotherapy and chemoradiation improved overall survival. This was without a recurrence in comparison with chemoradiation alone in people with locally advanced nasopharyngeal carcinoma. This study used the induction chemotherapy agents gemcitabine and cisplatin.

A 2021 clinical review found that induction treatment with gemcitabine and cisplatin may also help manage symptoms of locally advanced nasopharyngeal carcinoma.

Lung cancer

According to a 2016 study, carboplatin-based induction chemotherapy may help improve survival rates in people with stage 2 or 3 non-small cell lung cancer. Carboplatin is an injectable chemotherapy agent.

This induction chemotherapy may help improve survival rates and rates of recurrence in people with stage 2 or 3 non-small cell lung cancer.

Learn more about non-small cell lung cancer here.

Breast cancer

Some medical professionals use the terms neoadjuvant chemotherapy and induction chemotherapy interchangeably. However, neoadjuvant chemotherapy specifically refers to induction chemotherapy a person receives before surgery. Doctors may recommend this chemotherapy technique to help shrink a tumor so that the subsequent surgical procedure is less extensive.

A 2019 study found that neoadjuvant chemotherapy improved survival rates in people with locally advanced breast cancer. However, this study did not show that this technique improved the chances of the cancer not recurring in the area of the original tumor.

Learn more about breast cancer here.

Pancreatic cancer

Irreversible electroporation ablation (IEA) is a procedure that involves using high-voltage electrical impulses to damage and destroy cancer cells. Doctors may recommend this treatment for individuals with locally advanced pancreatic cancer.

A 2018 review investigated the effects of combined induction chemotherapy and IEA on locally advanced pancreatic adenocarcinoma. It found that this combination of treatments can help increase survival rates in people with this form of pancreatic cancer.

Learn more about pancreatic cancer here.

Induction chemotherapy has associations with certain risks and disadvantages. These may vary according to various factors, including:

  • cancer type and severity
  • induction chemotherapy agents
  • induction chemotherapy treatment dosages and regimen
  • whether the person receives additional cancer treatments, such as radiation therapy or surgery
  • the person’s age and overall health

Some possible risks of induction chemotherapy are below.

Side effects

People undergoing induction chemotherapy typically receive high doses of one or more chemotherapy drugs in an effort to destroy as many cancerous cells as possible. However, chemotherapy drugs indiscriminately target any type of fast-dividing cell within the body, whether it is cancerous or not. This can result in side effects.

According to the United Kingdom’s National Health Service (NHS), people receiving intensive induction chemotherapy for AML may experience several side effects, including:

The above side effects may disappear after a person completes or otherwise stops their treatment.

The ACS adds that someone receiving cytarabine during the induction phase of AML treatment may develop eye dryness or balance issues. If this occurs, a doctor may consider reducing the dose or stopping the treatment.


The ACS states that people undergoing chemotherapy treatment are more prone to developing infections. This is because chemotherapy drugs damage the cells of the immune system, making individuals more susceptible to bacteria and viruses. However, this tends to be a short-term effect, with natural immunity recovering once a person stops chemotherapy treatment.

Tumor lysis syndrome

Tumor lysis syndrome (TLS) is a potential side effect of chemotherapy, particularly high dose induction chemotherapy.

TLS occurs in response to the sudden and widespread destruction of cancer cells. In TLS, the cancer cells break down, releasing their toxic chemicals into the bloodstream at a rate faster than the body is able to clear. This can trigger potentially life threatening electrolyte imbalances and other metabolic issues.

Psychological effects

Induction chemotherapy is an intensive treatment. While it can improve survival rates in many cases, it can significantly affect a person’s immediate health and day-to-day life. In turn, this can take a toll on their mental health.

According to the Centers for Disease Control and Prevention (CDC), people who receive chemotherapy may also experience problems with thinking and memory either during or after their treatment. Cancer survivors refer to this as “chemo brain.” The condition can exacerbate feelings of anger, frustration, or anxiety a person may already feel in relation to their diagnosis or treatment.

Induction chemotherapy is a first-line chemotherapy treatment that aims to destroy as many cancer cells as possible within a person’s body. An individual may receive induction chemotherapy before other cancer treatments, such as maintenance chemotherapy, radiation therapy, or surgery.

Induction therapy may form part of the treatment plan for various types of cancer, including AML and cancers of the head and neck, breast, lung, and pancreas. The therapy typically involves a combination of chemotherapy drugs. The types of drugs a person receives will depend on the cancer type and severity as well as the individual’s age and overall health.

Research indicates that induction chemotherapy can improve survival rates in many cases. However, people should be aware of the potential side effects and risks. A person can discuss these with their doctor before undergoing treatment.