title: [State-of-the art treatment of locally advanced and metastatic non-small cell lung cancer].
abstract: Despite the poor mortality figures from lung cancer, advances have been observed in the treatment of advanced (stages IIIB and IV) non-small cell lung cancer (NSCLC). In the first instance, such advances have been achieved thanks to chemotherapy (CT) consisting of platinum-based compounds (results demonstrated in several phase III studies) and then thanks to newer cytotoxic agents such as gemcitabine. Used as monotherapy, gemcitabine provides a marked benefit compared to the standard treatment consisting of etoposide/cisplatin (EC) (21% objective response, 39% survival at 1 year). A good efficacy profile of this agent in combination with platinum analogs was also observed in randomized phase III studies, confirming the significant higher survival obtained with the gemcitabine/cisplatin (GC) combination (in GC versus C protocols and that comparing four doublets of CT). Results observed with G without platinum analogs are comparable to those of treatment with a platinum agent. Other studies conducted with triplets of CT need to be confirmed. Newer non-cytotoxic agents have also been studied: the anti-vascular endothelial growth factor monoclonal antibody with or without CT may prolong survival; docetaxel improves overall survival outcomes compared to palliative therapy. In locally advanced stages, advances have been made possible by radiochemotherapy (RT/CT): several phase II and phase III studies using EC and RT have been conducted. Lastly, in induction treatments, CT appears to provide improvement.
authors.affiliation: University of Colorado Cancer Center, Denver, CO 80220-3706, USA. paul.bunn@uchsc.edu
authors.forename: P A
authors.initials: PA
authors.lastname: Bunn
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents