Potential Treatment Options After First-Line Chemotherapy for Advanced NSCLC: Maintenance Treatment or Early Second-Line?
Potential Treatment Options After First-Line Chemotherapy for Advanced NSCLC: Maintenance Treatment or Early Second-Line?
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DOI：
10.1634/theoncologist.2008-0152
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发表时间：
2009-01-01
期刊：
影响因子：
5.8
通讯作者：
Ciardiello, Fortunato
中科院分区：
文献类型：
--
作者：
Gridelli, Cesare;Maione, Paolo;Ciardiello, Fortunato
尽管目前晚期非小细胞肺癌(NSCLC)患者的治疗方案已经取得了实质性进展，但大多数患者的总体生存状况仍然很差。目前正在研究的旨在延长非小细胞肺癌患者生存的策略之一是在一线化疗后使用化疗药物或分子靶向药物进行维持治疗。此外，这可以由诱导方案中包含的药物或其他非交叉耐药药物组成。根据目前可用的数据，使用不同的非交叉耐药药物(即早期二线治疗)进行维持治疗可能是最有希望的策略。考虑到患者刚刚完成了毒性特别大的铂类化疗，选择用于早期二线治疗的药物应该是耐受性良好的药物。延长靶向药物而不是化疗可以提供更长的无进展和总体生存时间，而不会增加毒性。然而，目前，只有无进展生存被证明与维持方法一致优越；在将该策略定义为可能的治疗选择之前，有必要对生存益处进行评估。维持化疗在晚期非小细胞肺癌患者中的作用有待进一步研究。肿瘤学家2009；14：137-147
Although substantial progress has been made in the therapeutic options currently available for patients with advanced non-small cell lung cancer (NSCLC), the overall survival profile remains poor for most patients. One of the strategies currently under investigation with the aim of prolonging survival in NSCLC patients is maintenance treatment with either a chemotherapeutic agent or a molecularly targeted agent after first-line chemotherapy. Moreover, this can consist of drugs included in the induction regimen or other noncrossresistant agents. With the currently available data, maintenance treatment with a different noncrossresistant agent (i.e., an early second-line treatment) is perhaps the most promising strategy. The drug chosen for the early second-line treatment should be a well-tolerated agent, considering that patients have just completed a particularly toxic platinum-based chemotherapy. Extending treatment with targeted agents rather than chemotherapy can provide longer progression-free and overall survival times without increasing toxicity. However, at the moment, only progression-free survival has been shown to be consistently superior with maintenance approaches; the evaluation of survival benefits is warranted before defining this strategy as a possible treatment option. Further studies are warranted to establish the role of maintenance chemotherapy in patients with advanced NSCLC. The Oncologist 2009; 14: 137-147