title: [What choice of first-line treatment?].
abstract: Treatment of advanced non-small cell lung cancer has evolved last years, until an individualized approach, notably according to patient characteristics, histology, and molecular profile of the tumor. So, the presence of EGFR mutations allows the administration of gefitinib in first line, with response rate around 70% and a progression-free survival around 12 months. If there is no EGFR mutation, the treatment consists in cytotoxic chemotherapy, according to histology. Indeed, non squamous carcinomas are accessible to a platin-pemetrexed doublet, and squamous carcinomas to another platin-based doublet. Besides, new molecular targets are identified, with corresponding targeted treatment. So, the EML4 - ALK translocation is accessible to a treatment by crizotinib, with response rate around 60-70%.
authors.affiliation: DMAS pneumologie, hôpital Albert Michallon, BP217, 38043 Grenoble cedex 9, France. dmoro.pneumo@chu-grenoble.fr
authors.forename: D
authors.initials: D
authors.lastname: Moro-Sibilot
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000235:genetics; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality; D000077547:Crizotinib; D066246:ErbB Receptors / Q000235:genetics; D019317:Evidence-Based Medicine; D000077156:Gefitinib; D018773:Genes, erbB-1 / Q000235:genetics; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality; D015514:Oncogene Proteins, Fusion / Q000235:genetics; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors*; D011720:Pyrazoles / Q000008:administration & dosage; D011725:Pyridines / Q000008:administration & dosage; D011788:Quality of Life; D011799:Quinazolines / Q000008:administration & dosage; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D014178:Translocation, Genetic
chemical_list: D014408:Biomarkers, Tumor; C522504:EML4-ALK fusion protein, human; D015514:Oncogene Proteins, Fusion; D047428:Protein Kinase Inhibitors; D011720:Pyrazoles; D011725:Pyridines; D011799:Quinazolines; D000077547:Crizotinib; D066246:ErbB Receptors; D011505:Protein-Tyrosine Kinases; D000077156:Gefitinib