[Recent development of the standards of treatment of lung cancer].
Non-small cell lung cancer (NSCLC) knows important changes with the development of the use of chemotherapy not only in the advanced forms but also in a perioperative setting. In early stage disease, a wedge resection seems to be sufficient in the tumours with a diameter less than 2 cm and presenting as ground-glass opacity. In all other cases, at least a lobectomy is mandatory with a mediastinal dissection. There have been numerous technical improvements regarding radiation therapy which should lead to improved quality control ... and the need to revisit some concepts among which postoperative radiation therapy. Targeted therapies have been the real novelty in the treatment of non-small cell lung cancer. The inhibitors of EGFR (monoclonal antibodies and tyrosine kinase inhibitors) have been studies with upfront chemotherapy in advanced NSCLC without any benefit. However, they have proved useful in second line setting and in first line setting in diffuse bronchioloalveolar carcinoma. The targeted therapy bevacizumab (Avastin) is now the standard of the treatment of advanced NSCLC in combination with carboplatine and paclitaxel in the United States, whereas its combination with cisplatin and gemcitabine is still under investigation in Europe. Regarding small-cell lung cancer, there has been no real novelty, the standard treatment remains unchanged.
Quoix
Elisabeth
E
Département de pneumologie, hôpitaux universitaires, 67091 Strasbourg. elisabeth.quoix@chru-strasbourg.fr
D002282:Adenocarcinoma, Bronchiolo-Alveolar / Q000601:surgery; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery*; D018288:Carcinoma, Small Cell / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D020360:Neoadjuvant Therapy; D011013:Pneumonectomy; D018714:Radiotherapy, Adjuvant