The End of Nihilism: Systemic Therapy of Advanced Non-Small Cell Lung Cancer.
Lung cancer is the leading cause of cancer death in the United States and many other parts of the world. Non-small cell lung cancer (NSCLC) comprises 85-90% of lung cancers. Historically, the expected survival of patients with advanced disease has been estimated in months. In recent years, however, lung cancer has come to be seen as a treatable disease with multiple therapeutic options. Enormous advances in the understanding of its pathways and mechanisms have enabled personalized therapy in NSCLC. The evolving approach to therapy focuses on genomic profiling of the tumors to find molecular targets and develop specific agents for individualized therapy. In addition, maintenance therapy has emerged as a valid approach, and the choice of chemotherapy now varies by histology. Most recently, immunotherapy with checkpoint inhibitors has shown promising results, with impressive durations of response and a tolerable toxicity profile. Together, these discoveries have improved overall survival substantially in patient populations that have access to these advancements. We review the clinical data surrounding these impressive improvements.
Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, Nebraska 68198.
Vinicius
V
Ernani
Winship Cancer Institute, Emory University, Atlanta, Georgia 30322.
Conor E
CE
Steuer
Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Deerfield Beach, Florida 33442; email: mjahanzeb@med.miami.edu.
Mohammad
M
Jahanzeb
D000077548:Anaplastic Lymphoma Kinase; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D000074322:Antineoplastic Agents, Immunological / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000235:genetics* / Q000556:secondary; D018773:Genes, erbB-1 / Q000235:genetics; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000235:genetics* / Q000473:pathology; D060046:Maintenance Chemotherapy; D058990:Molecular Targeted Therapy; D009154:Mutation; D017671:Platinum Compounds / Q000008:administration & dosage; D020794:Receptor Protein-Tyrosine Kinases / Q000235:genetics
D020533:Angiogenesis Inhibitors; D000074322:Antineoplastic Agents, Immunological; D017671:Platinum Compounds; D000077548:Anaplastic Lymphoma Kinase; D020794:Receptor Protein-Tyrosine Kinases
advanced NSCLC; chemotherapy; immunotherapy; maintenance therapy; targeted therapy