Elsevier

Cancer Treatment Reviews

Volume 34, Issue 6, October 2008, Pages 521-526
Cancer Treatment Reviews

ANTI TUMOUR TREATMENT
Advances in the treatment of non-small cell lung cancer

https://doi.org/10.1016/j.ctrv.2008.03.124Get rights and content

Summary

While there have been advances in the treatment of lung cancer, they have been marginal in comparison with recent advances in the chemotherapy and molecularly targeted treatment of breast cancer, colorectal cancer and genitourinary cancer. Lung cancer is an extremely difficult disease to treat, and to obtain positive results and to develop new standard treatment. The results of clinical trial on gefitinib and erlotinib suggest that the evaluation of molecular target drugs seems to be quite difficult in unselected patient population and may be different from cytotoxic drugs. We need to find out specific molecular biomarkers for each drug. With global studies in view, it will be essential to obtain even more significant results by sophisticated clinical trials in selected patient populations and contribute to improving the treatment outcome of lung cancer patients.

Section snippets

First-line chemotherapy

The efficacy of lung cancer chemotherapy with cytotoxic anticancer agents has reached a plateau,2, 3, 4 and under the present circumstances it is difficult to expect any cytotoxic novel anticancer agents to become available although some hope exists in assessment of the efficacy of pemetrexed against adenocarcinoma,5 the significance of TS1,6, etc. The statement of “the results of treatment with 2-drug combinations consisting of cisplatin (CDDP) or carboplatin (CBDCA) and a new drug are the

Expectations of molecularly targeted therapy

When Epidermoid Growth Factor Receptor Thyrosine kinase Inhibitors (EGFR-TKIs) became available, a great progress was expected in the treatment of non-small cell lung cancer.14, 15 However, lung cancer investigators were surprised to find that according to the results of the Iressa NSCLC trial Assessing Combination Treatment (INTACT) 1 and 2 studies16, 17 and the TALENT and TRIBUTE studies18, 19 EGFR-TKIs provided no efficacy in addition to standard chemotherapy. Because the response rate to

Adjuvant chemotherapy

The field of adjuvant chemotherapy in non-small cell lung cancer has changed totally over the last 5 years. Until ASCO2003, there was no evidence except for a meta-analysis of MRC, that chemotherapy may have a role. However, beginning with the presentation of International Adjuvant Lung Cancer Trial (IALT) study by LeChavalier,40 there have been five randomized controlled studies that have been reported to show improved survival. According to the Lung Adjuvant Cisplatin Evaluation (LACE)

Conflict of interest statement

I have no potential conflict of interest to disclose except for stock option of Takeda pharmaceutical company.

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