Therapeutic integration of new molecule-targeted therapies with radiotherapy in lung cancer

摘要: Lung cancer is the most common form of disease and leading cause deaths worldwide. Non-small-cell lung (NSCLC) accounts for approximately 80-85% all cancers. Forty percent cases present with stage III, many them are considered inoperable (staged IIIA mediastinal lymph node involvement) or IIIB disease. Concurrent platinum-based chemotherapy thoracic radiation has demonstrated survival benefits in these patients. We review role new target agents combination radiotherapy III NSCLC. Antiangiogenics improve tumor oxygenation thereby improving therapeutic efficacy irradiation models. Bevacizumab shown high toxicity. However, other antiangiogenic more promising. Radiation activates epidermal growth factor receptor (EGFR) pathways, inducing radioresistance, cell proliferation enhanced DNA repair. After promising data from preclinical models early clinical trials, cetuximab did not show any benefit a recent phase trial. Panitumumab nimotuzumab under evaluation. Gefitinib been investigated unresectable NSCLC, but results maintenance treatment after chemoradiotherapy were encouraging. Erlotinib also tested II trial chemoradiotherapy. Other pathways being studied, such as m-TOR pathway, bortezomib, heat shock protein 90 (Hsp90) inhibition, histone deacetylase inhibitors (HDACS), aurora kinases, mitogen activated kinases (MARK) PARP inhibitors.