Management of Advanced Non-Small Cell Lung Cancer

摘要: Patients with non-small cell lung cancer (NSCLC) have poor survival prospects, as most advanced disease at diagnosis. Chemotherapy can be used to treat these patients if their performance status is good, although there are geographical differences in chemotherapy use. Combination regimens usually because monochemotherapy has only modest efficacy. The nucleoside analogue gemcitabine one of several new chemotherapies for NSCLC which been developed recent years. Like other available drugs, it efficacy against when monotherapy [19 26% objective (partial plus complete) response rate]. Gemcitabine relatively well tolerated, causing few serious adverse effects. Myelosuppression the common reason dosage adjustment during monotherapy, but such adjustments infrequent overall. Flu-like symptoms and fever, elevated hepatic enzyme levels, nausea vomiting mild or moderate. Dosage reduction treatment withdrawal exception rather than rule receiving monotherapy. combination cisplatin shown good antitumour (26 54% rate) NSCLC, limited phase III data suggest that produces rates significantly higher those some older ‘standard’ etoposide (although appears similar). grade 3 4 myelosuppression many patients, this generally proved manageable not clinical Data from comparisons currently recommended (which include newer agents e.g. paclitaxel vinorelbine) yet available. now a established approved use countries, its precise role an indication numerous options clearly still evolving. Gemcitabine-containing being tested number trials studies awaited interest. benign tolerability profile may prove useful elderly (limited group favourable) coexisting states, since tolerance toxicities likely lower groups patients. Non-cisplatin-based investigated attempt further improve play significant respect.