Targeted therapies for stage III non-small cell lung cancer: integration in the combined modality setting.
Combined modality therapy represents current standard therapy for locoregionally advanced non-small cell lung cancer. In particular, concomitant chemoradiotherapy has emerged as the preferred approach. At the same time, efforts to increase locoregional and systemic antitumor activity are necessary to further improve long-term survival rates for these patients. In recent years, multiple cellular targets have emerged in the development of novel antitumor therapies. Several of these are of high relevance in the carcinogenesis of lung cancer including the epidermal growth factor receptor (EGFR), the ras signaling pathway, tumor angiogenesis, and cyclooxygenase-2 (COX-2) expression. Novel agents directed against these targets are currently under development with promising early results in non-small cell lung cancer when administered as single agents or in combination with chemotherapy in stage IV or recurrent disease. Similarly their use with concurrent radiation therapy is supported by preclinical models. Selected early clinical trials utilizing these agents in combination with radiotherapy or chemoradiotherapy are discussed.
Vokes
Everett E
EE
Section of Hematology/Oncology, University of Chicago Medical Center, University of Chicago, 5841 S. Maryland Avenue, MC 2115, Chicago, IL 60637-1470, USA. evokes@medicine.bsd.uchicago.edu
Choy
Hak
H
D019883:Alkyl and Aryl Transferases / Q000037:antagonists & inhibitors* / Q000494:pharmacology; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000494:pharmacology*; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000494:pharmacology*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000532:radiotherapy* / Q000601:surgery; D000068579:Celecoxib; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D003546:Cysteine Endopeptidases; D004791:Enzyme Inhibitors / Q000008:administration & dosage / Q000494:pharmacology*; D051231:Farnesyltranstransferase; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy* / Q000601:surgery; D009097:Multienzyme Complexes / Q000037:antagonists & inhibitors; D046988:Proteasome Endopeptidase Complex; D011720:Pyrazoles; D018714:Radiotherapy, Adjuvant; D013449:Sulfonamides / Q000008:administration & dosage / Q000494:pharmacology*
D020533:Angiogenesis Inhibitors; D000970:Antineoplastic Agents; D004791:Enzyme Inhibitors; D009097:Multienzyme Complexes; D011720:Pyrazoles; D013449:Sulfonamides; D019883:Alkyl and Aryl Transferases; D051231:Farnesyltranstransferase; D003546:Cysteine Endopeptidases; D046988:Proteasome Endopeptidase Complex; D000068579:Celecoxib