title: Second-line treatment in advanced non-small-cell lung cancer in the epidermal growth factor receptor wild-type population: review of patient profile.
abstract: After progression during first-line treatment in advanced non-small-cell lung cancer (NSCLC), a large percentage of patients are candidates for second-line treatment. The majority do not have epidermal growth factor receptor-activating mutations (EGFRwt). This article reviews the treatment options available for this subpopulation of patients, which includes essentially docetaxel, pemetrexed and erlotinib. These drugs all have similar efficacy, both in terms of objective response rates and overall survival, although with different toxicity profiles. In view of the similar efficacy of the three agents (docetaxel, pemetrexed and erlotinib) in the second-line treatment of NSCLC in the EGFRwt population, and although there are no prospective studies on predictive variables or new molecular markers available, selection of the treatment will depend on the histological type (pemetrexed); patient preference (oral as opposed to intravenous formulation); the presence of comorbid conditions; quality of life; previous or residual toxicities; the risk of neutropenia; response to and the duration of the first-line chemotherapy; and history of smoking.
authors.affiliation: aMedical Oncology Service, Lucus Augusti University Hospital (HULA), Lugo bMedical Oncology Service, University Hospital of Vigo (CHUVI) cMedical Oncology Service, Povisa Hospital, Vigo dMedical Oncology Service, University Hospital Complex of Ourense (CHOU), Ourense eMedical Oncology Service, Arquitecto Marcide - Novoa Santos Hospital, Ferrol fMedical Oncology Service, Oncology Center of Galicia, A Coruña, Spain.
authors.forename: Sergio
authors.initials: S
authors.lastname: Vázquez
authors.forename: Martín
authors.initials: M
authors.lastname: Lázaro
authors.forename: José Luis
authors.initials: JL
authors.lastname: Fírvida
authors.forename: Lucía
authors.initials: L
authors.lastname: Santomé
authors.forename: Javier
authors.initials: J
authors.lastname: Afonso
authors.forename: Margarita
authors.initials: M
authors.lastname: Amenedo
authors.forename: Joaquín
authors.initials: J
authors.lastname: Casal
mesh_terms: D000818:Animals; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000556:secondary; D000077143:Docetaxel; D066246:ErbB Receptors / Q000235:genetics / Q000378:metabolism*; D000069347:Erlotinib Hydrochloride; D005971:Glutamates / Q000627:therapeutic use*; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D000068437:Pemetrexed; D011799:Quinazolines / Q000627:therapeutic use*; D043823:Taxoids / Q000627:therapeutic use*
chemical_list: D000970:Antineoplastic Agents; D005971:Glutamates; D011799:Quinazolines; D043823:Taxoids; D000068437:Pemetrexed; D000077143:Docetaxel; D006147:Guanine; D000069347:Erlotinib Hydrochloride; D066246:ErbB Receptors