First-line treatment in advanced non-small-cell lung cancer: the emerging role of the histologic subtype.
Lung cancer is the leading cause of cancer mortality worldwide. During the past quarter of a century, there have been definite steps forward in understanding the biology of this disease. However, progress in the treatment of advanced non-small-cell lung cancer (NSCLC) has been more elusive and has not been associated with a realistic probability of long-term survival. For this disease, platinum-based chemotherapy is currently the standard treatment. Numerous studies have compared various platinum doublets and have concluded that all such combinations are comparable in their clinical efficacy. Moreover, several trials evaluating different chemotherapy regimens in NSCLC have failed to document a difference based on histology. Recent evidence suggests that histology represents an important variable in the decision making. This review will discuss this new evidence in the first-line treatment of advanced NSCLC, focusing on different possible therapeutic approaches according to histologic subtype.
Tiseo
Marcello
M
Medical Oncology Unit, University Hospital of Parma, Via Gramsci 14, 43100 Parma, Italy. mtiseo@ao.pr.it
Bartolotti
Marco
M
Gelsomino
Francesco
F
Ardizzoni
Andrea
A
D000230:Adenocarcinoma / Q000145:classification / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000068258:Bevacizumab; D018287:Carcinoma, Large Cell / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D002289:Carcinoma, Non-Small-Cell Lung / Q000145:classification / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D017322:Clinical Trials, Phase II as Topic; D017326:Clinical Trials, Phase III as Topic; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D019468:Disease Management; D005971:Glutamates / Q000008:administration & dosage; D006147:Guanine / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D016756:Immunoglobulins, Intravenous; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D015337:Multicenter Studies as Topic; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D010166:Palliative Care; D000068437:Pemetrexed; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D000093542:Gemcitabine
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000972:Antineoplastic Agents, Phytogenic; D005971:Glutamates; D016756:Immunoglobulins, Intravenous; D009944:Organoplatinum Compounds; D000068437:Pemetrexed; D003841:Deoxycytidine; D000068258:Bevacizumab; D006147:Guanine; C525021:figitumumab; D000093542:Gemcitabine