title: Safety profiles of first-line therapies for metastatic non-squamous non-small-cell lung cancer.
abstract: BACKGROUND
  Lung cancer still represents the leading cause of death for cancer. About the 70% of diagnosis are in advanced-stage. Non-small-cell lung cancer (NSCLC) represents the 85% of all diagnosed lung cancers and non-squamous histology represents the 40% of all NSCLC. First-line therapies increase survival, control symptoms and improve quality of life, compared with best supportive care. It is crucial to choose a treatment with a low impact on patient's life considering the related toxicities.
  
  
  METHODS
  Adverse events (AEs) of first-line therapies for non-squamous NSCLC are here reviewed and discussed, from evidences in clinical trials conducting to drugs approval.
  
  
  CONCLUSIONS
  For advanced disease, palliation and preserving patients QoL are still the primary goal of treatment. Therefore, differing toxicity profiles are often a deciding factor in first-line and also maintenance setting for non-squamous NSCLC. Special attention is necessary to renal function and drugs' nephrotoxicity. Moreover, it is to consider the specific AEs of drugs classes: hypertension, bleeding, and proteinuria, for anti-VEGF therapy; skin toxicity, diarrhea, interstitial lung disease for TKIs; vision disorders, and hepatotoxicity for ALK-inhibitor. It is important to select patients for a treatment on the basis of their comorbidities and the presence of risk factors.
authors.affiliation: a Department of Experimental Medicine , University 'Sapienza' , Rome , Italy.
authors.forename: Tania
authors.initials: T
authors.lastname: Losanno
authors.affiliation: b Division of Medical Oncology , S.G. Moscati Hospital , Avellino , Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Gridelli
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D018579:Patient Selection; D011788:Quality of Life; D012129:Respiratory Function Tests; D012307:Risk Factors
chemical_list: D000970:Antineoplastic Agents
keywords: Afatinib; bevacizumab; crizotinib; erlotinib; first-line therapy; gefitinib; maintenance therapy; non-squamous non-small-cell lung cancer; pemetrexed