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Find out what CAVE is, how you have it and other important information about having CAVE. 

CAVE is a combination of chemotherapy drugs used to treat small cell lung cancer. 

It is made up of the drugs: 

  • cyclophosphamide
  • doxorubicin (also called Adriamycin)
  • vincristine
  • etoposide

How it works

These chemotherapy drugs destroy quickly dividing cells, such as cancer cells.

How you have it

You have the drugs cyclophosphamide, doxorubicin and vincristine into your bloodstream (intravenously). You might have etoposide into your bloodstream or as capsules that you swallow.

Drugs into your bloodstream

You have the treatment through a drip into your arm. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.

You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.

Taking your capsules

Etoposide capsules are pink and quite large. You swallow them whole with a full glass of water. You take them on an empty stomach. This means either an hour before a meal or 2 hours afterwards.

You must take capsules according to the instructions your doctor or pharmacist gives you.

You should take the right dose, not more or less.

Never stop taking a cancer drug without talking to your specialist first.

Make sure that you wash your hands thoroughly after you take the capsules. Store them where children can’t reach them. And return any unused capsules to the pharmacy.

When you have CAVE

You usually have CAVE chemotherapy as cycles of treatment. You might have up to 6 cycles. Each cycle lasts 3 weeks.

On the first day of the cycle you have:

  • doxorubicin and vincristine as slow injections into your bloodstream
  • a salt water (saline) drip
  • cyclophosphamide as a drip or slow injection

It takes about an hour to have all 3 drugs. You may have etoposide into your bloodstream at the same time or as capsules.

If you have capsules, you take them on the first 3 days of each cycle.

You have no treatment for the rest of the 3 week cycle. You then start the next cycle of treatment.

Tests during treatment

You have blood tests before starting treatment and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

Side effects

Important information

Other medicines, foods and drink

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Pregnancy and contraception

This treatment might harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.


You may not be able to become pregnant or father a child after treatment with these drugs. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment. Women may be able to store eggs or ovarian tissue but this is rare.


Don’t breastfeed during this treatment because the drugs may come through in your breast milk.

Treatment for other conditions

Always tell other doctors, nurses or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.


Don’t have immunisations with live vaccines while you’re having treatment and for at least 6 months afterwards.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and Zostavax (shingles vaccine).

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine
  • be in contact with other people who've had live vaccines as injections

Avoid contact with people who’ve had live vaccines taken by mouth (oral vaccines). This includes the rotavirus vaccine given to babies. The virus is in the baby’s urine for up to 2 weeks and can make you ill. So, you mustn't change their nappies for 2 weeks after their vaccination.

You also need to avoid anyone who has had oral polio or typhoid vaccination recently.

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Information and help

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