title: First-line systemic treatment of advanced stage non-small-cell lung cancer in Asia: consensus statement from the Asian Oncology Summit 2009.
abstract: Non-small-cell lung cancer (NSCLC) is an increasing global challenge, especially in low-income countries. Most guidelines for the management of advanced-stage NSCLC have limited effect in countries with resource constraints. Following a systematic literature search, we present an overview of the management of advanced-stage NSCLC in the first-line setting, discuss resources required for systemic therapy, and provide treatment recommendations stratified to four resources levels. Treatment guidelines appropriate for different resource levels offer a realistic approach to management of advanced-stage NSCLC, by recognising the limitations of a particular health-care system. Although there are many barriers to cancer control in low-resource countries, these can be overcome by using measures that are culturally appropriate, economically feasible, and evidence-based. Initiatives include strategic planning, tobacco control, training of health-care workers, access to therapeutic agents, acquisition of information, public education, and alliances with established institutions and international organisations.
authors.affiliation: Department of Haematology-Oncology, National University Hospital, and Cancer Science Institute of Singapore, National University of Singapore, Singapore. ross_soo@nuhs.edu.sg
authors.forename: Ross A
authors.initials: RA
authors.lastname: Soo
authors.forename: Benjamin O
authors.initials: BO
authors.lastname: Anderson
authors.forename: Byoung Chul
authors.initials: BC
authors.lastname: Cho
authors.forename: Chih-Hsin
authors.initials: CH
authors.lastname: Yang
authors.forename: Meilin
authors.initials: M
authors.lastname: Liao
authors.forename: Wan-Teck
authors.initials: WT
authors.lastname: Lim
authors.forename: Peter
authors.initials: P
authors.lastname: Goldstraw
authors.forename: Tony S
authors.initials: TS
authors.lastname: Mok
mesh_terms: D000970:Antineoplastic Agents / Q000191:economics / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000191:economics / Q000592:standards / Q000627:therapeutic use*; D001208:Asia / Q000453:epidemiology; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics / Q000401:mortality; D003226:Congresses as Topic; D003362:Cost-Benefit Analysis; D003906:Developing Countries / Q000191:economics; D016527:Drug Costs; D019317:Evidence-Based Medicine; D019983:Guideline Adherence; D017048:Health Care Costs; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics / Q000401:mortality; D008495:Medical Oncology / Q000191:economics / Q000592:standards; D009367:Neoplasm Staging; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents