Systemic treatment for advanced (stage IIIb/IV) non-small cell lung cancer: more treatment options; more things to consider. Conclusion.

摘要: Chemotherapy for non-small cell lung cancer (NSCLC) can prolong survival and improve quality of life, but the majority advanced stage patients succumb to disease within 2 years, meaning that there is room improvement. The standard chemotherapy NSCLC involves one a number doublets have been shown when compared with single agents or best supportive care. These are generally comparable in terms efficacy, differing primarily their toxicity profiles. However, encouraging new options may be approaching, including therapies targeted specific patient subpopulations, use combinations current drugs produce synergistic effects. Targeted include anti-epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) erlotinib gefitinib, EGFR monoclonal antibody cetuximab, vascular endothelial (VEGF) such as sorafenib, small molecule TKI, bevacizumab, recombinant VEGF antibody. Most attempts combine EGFR-targeted produced poor results, possibly result antagonism between TKIs chemotherapy. Positive results bevacizumab suggest VEGF-rather than better combined Other being tested enzastaurin, an oral serine threonine inhibitor; vinflunine, vinca alkaloid; dihydrofolate reductase inhibitors; thymidylate synthase inhibitors. Combinations therapies, especially those acting via different mechanisms, hold promise improvements survival, careful testing required determine optimum available where fit into armamentarium.