[The place of targeted therapies in the management of non-small cell bronchial carcinoma. Methodology of the development of targeted therapies in pulmonary oncology].
The development of new anticancer agents specifically targeting the molecular processes involved in carcinogenesis is a major step forward in the treatment of patients with lung cancer. Preclinical models often show a cytostatic mechanism of action and predict an improved toxicity profile compared to traditional cytostatic drugs. This means that a standard development design based upon tumour shrinkage is not appropriate for these agents. The development of targeted therapies requires a new model for clinical phase I and II trials, with careful selection of patients who might benefit from treatment and adapted endpoints to establish that growth inhibition can be translated into a clinical benefit. Some targeted agents may have been discarded because of the use of inappropriate traditional endpoints during their development. A greater investment with additional implementation of correlative translational and pharmacodynamic studies during early development is crucial before going to phase III trials.
Pérol
M
M
Service de Pneumologie, Hôpital de la Croix-Rousse, Lyon, France. maurice.perol@chu-lyon.fr
D002283:Carcinoma, Bronchogenic / Q000188:drug therapy*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D008495:Medical Oncology; D015272:Pulmonary Medicine