title: Maintenance therapy in NSCLC: why? To whom? Which agent?
abstract: Maintenance therapy is emerging as a treatment strategy in the management of advanced non small cell lung cancer (NSCLC). Initial trials addressing the question of duration of combination chemotherapy failed to show any overall survival benefit for the prolonged administration over a fixed number of cycles with an increased risk for cumulative toxicity. Nowadays several agents with different ways of administration and a different pattern of toxicity have been formally investigated in the maintenance setting. Maintenance strategies include continuing with an agent already present in the induction regimen or switching to a different one. Taking into consideration that no comparative trials of maintenance with different chemotherapy drugs or targeted agents have been conducted, the choice and the duration of maintenance agents is largely empirical. Furthermore, it is still unknown and it remains an open question if this approach needs to be proposed to every patient in the case of partial/complete response or stable disease after the induction therapy. Here, we critically review available data on maintenance treatment, discussing the possibility to tailor the right treatment to the right patient, in an attempt to optimize costs and benefits of an ever-growing panel of different treatment options.
authors.affiliation: Thoracic Oncology Unit, University of Turin, AOU, San Luigi Orbassano, Italy. silvia.novello@unito.it
authors.forename: Silvia
authors.initials: S
authors.lastname: Novello
authors.forename: Michele
authors.initials: M
authors.lastname: Milella
authors.forename: Marcello
authors.initials: M
authors.lastname: Tiseo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Banna
authors.forename: Diego
authors.initials: D
authors.lastname: Cortinovis
authors.forename: Massimo
authors.initials: M
authors.lastname: Di Maio
authors.forename: Marina
authors.initials: M
authors.lastname: Garassino
authors.forename: Paolo
authors.initials: P
authors.lastname: Maione
authors.forename: Olga
authors.initials: O
authors.lastname: Martelli
authors.forename: Tiziana
authors.initials: T
authors.lastname: Vavalà
authors.forename: Emilio
authors.initials: E
authors.lastname: Bria
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*
chemical_list: D000970:Antineoplastic Agents