Second-line treatment for non-small-cell lung cancer: one size does not fit all.
After progression following first-line treatment, many patients with advanced non-small-cell lung cancer (NSCLC) still have a good performance status and can be considered for further treatments. Based on 2 randomized phase III trials, docetaxel was the first approved second-line therapy associated with longer survival and better quality of life compared with best supportive care alone and vinorelbine or ifosfamide. Since then, other agents have been approved for the second-line treatment of NSCLC (ie, pemetrexed, erlotinib, and gefitinib). Recently, new molecular-targeted agents are being increasingly considered in this setting, above all, bevacizumab and vandetanib. The discovery and validation of predictive markers of efficacy for both chemotherapy drugs and the new targeted therapies is of primary importance for the selection of second-line treatment for all patients with advanced NSCLC.
Caponi
Sara
S
U.O. Oncologia 2 Universitaria, Azienda Ospedaliero-Universitaria Pisana, Polo Oncologico Area Vasta Nord-Ovest, Istituto Toscano Tumori, Italy.
Vasile
Enrico
E
Ginocchi
Laura
L
Tibaldi
Carmelo
C
Borghi
Francesca
F
D'Incecco
Armida
A
Lucchesi
Maurizio
M
Caparello
Chiara
C
Andreuccetti
Michele
M
Falcone
Alfredo
A
D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality; D002986:Clinical Trials as Topic; D018450:Disease Progression; D000077143:Docetaxel; D000069347:Erlotinib Hydrochloride; D000077156:Gefitinib; D005971:Glutamates / Q000008:administration & dosage / Q000627:therapeutic use; D006147:Guanine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality; D058990:Molecular Targeted Therapy; D000068437:Pemetrexed; D011379:Prognosis; D011799:Quinazolines / Q000008:administration & dosage / Q000627:therapeutic use; D043823:Taxoids / Q000008:administration & dosage / Q000627:therapeutic use
D000970:Antineoplastic Agents; D005971:Glutamates; D011799:Quinazolines; D043823:Taxoids; D000068437:Pemetrexed; D000077143:Docetaxel; D006147:Guanine; D000069347:Erlotinib Hydrochloride; D000077156:Gefitinib