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See Latest ArticlesTreatment of advanced lung cancer
Clinical Pulmonary Medicine, 05/20/09
Ou SHI et al. - In a review of the treatment of advanced lung cancer, it was reported that studies are underway to determine which pts will benefit from platinum-based chemotherapy. Randomized trials have shown that elderly pts or pts with performance status (PS) 2 also benefited from chemotherapy.
Methods- The majority of the lung cancer pts are diagnosed with advanced disease.
- Platinum-based doublet chemotherapy is the standard chemotherapy in the treatment of advanced non-small cell lung cancer (NSCLC) though non-platinum-based chemotherapy is an alternative possibility.
- Monoclonal antibodies that inhibit binding of vascular endothelial growth factors (VEGF), such as bevacizumab, or the epidermal growth factors (EGFR), such as cetuximab, have been shown to significantly prolonged overall survival (OS) in combination with platinum-based doublet chemotherapy in first-line treatment of NSCLC.
- Optimal number of cycles of first-line chemotherapy is between 3 and 4.
- Maintenance therapy with noncross-resistant agents after first-line treatment is still considered investigational.
- Oral EGFR tyrosine kinase inhibitor (TKI), erlotinib, has been approved for use as second-line or beyond in treatment of NSCLC based on superior survival benefit over best supportive care.
- NSCLC pts with EGFR activation mutations generally had better response to erlotinib and are generally found in Asian, never-smokers, females, and adenocarcinoma histology.
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