Sequential, alternating, and maintenance/consolidation chemotherapy in advanced non-small cell lung cancer : A review of the literature

摘要: A platinum-based doublet with a third-generation agent (paclitaxel, vinorelbine, gemcitabine, docetaxel) represents the standard first-line treatment for advanced non-small cell lung cancer patients good performance status (PS). Traditional chemotherapy provides response rates of 20%-40% and median survival 8-10 months. In an attempt to improve its outcome, alternative schedules have been proposed, namely sequential, alternating, maintenance/consolidation therapy. Sequential followed by single is feasible in PS; preliminary results from randomized phase III trials combination as comparator are promising, suggesting similar efficacy better toxicity profile sequential arm. The use agents option elderly frail unsuitable combination. Based on published so far, it unlikely that alternating strategy will be proven superior PS. However, sufficient evidence exists could appropriate or unfit individuals. Consolidation/maintenance may provide additional benefit achieving disease control after chemotherapy. Better seen when maintenance consists has active induction phase. Further evaluation this strategy, well consolidation/maintenance therapy targeted agents, warranted. conclusion, these approaches outcome selected cancer, but further needed. meantime, should still considered investigational.