Current approaches to advanced-stage non-small-cell lung cancer: first-line therapy in patients with a good functional status.
Lung cancer is the leading cause of cancer-related death among men and women in the United States. Approximately 80-85% of lung cancer cases are non-small-cell lung cancer (NSCLC), and approximately 65% of these patients have advanced-stage (IIIB/IV) disease at diagnosis. The median survival for patients with advanced-stage NSCLC treated with platinum-based chemotherapy is a disappointing 8-10 months. This article reviews the current status of chemotherapy in patients with a good functional status and evaluates the treatments in terms of efficacy, toxicity, survival, and impact on quality of life in the first-line treatment. Biologic agents such as bevacizumab and erlotinib have been investigated in phase III trials in the first- and second-line setting. These agents could play a role in select patient populations. This article also highlights some of the more promising new strategies, such as advances in pharmacogenomics and immune-based therapy. There is a clear need for improvement in the current standard of care. Well-designed clinical trials with appropriate patient selection, as well as continued efforts in translational research and pharmacogenomics, are crucial for progress in this disease.
Stinchcombe
Thomas E
TE
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill 27599-7305, USA.
Lee
Carrie B
CB
Socinski
Mark A
MA
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D006801:Humans; D007167:Immunotherapy; D008175:Lung Neoplasms / Q000188:drug therapy*; D009367:Neoplasm Staging; D017671:Platinum Compounds / Q000008:administration & dosage; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use
D000970:Antineoplastic Agents; D017671:Platinum Compounds; D047428:Protein Kinase Inhibitors; D066246:ErbB Receptors