Second-line chemotherapy for recurrent non-small cell lung cancer: do new agents make a difference?
Second-line chemotherapy for recurrent non-small cell lung cancer: do new agents make a difference?
复制标题
DOI：
10.1016/s0169-5002(00)00112-4
复制
发表时间：
2000-08-01
期刊：
影响因子：
5.3
通讯作者：
Buccheri, G
中科院分区：
文献类型：
--
作者：
Ferrigno, D;Buccheri, G
在经历了一定程度的虚无主义之后，化疗已成为晚期和转移性非小细胞肺癌（NSCLC）的标准治疗方法。新的化疗药物（长春瑞滨、紫杉烷类、吉西他滨和伊立替康）及其与顺铂的联合治疗显示出比标准方案更好的缓解率和生存率。这种生存期的增加是可能考虑在NSCLC患者中进行二线治疗的主要动机。在这方面，最有希望的药物可能是多西他赛，在一项包括最佳支持治疗组（BSC）的随机试验中，记录了7.6%的缓解率和更长的中位生存期（31周vs BSC的21周）。和更高质量的生活。其他II期研究使用多西他赛获得的缓解率为20%，1年生存率为40%。吉西他滨在这种情况下也显示出有趣的结果，缓解率为19%，中位生存率和1年生存率分别为34周和45%。由于相互矛盾的结果，紫杉醇的活性尚未得到很好的定义，值得进一步研究，而长春瑞滨和伊立替康的疗效令人沮丧。需要进行大型随机试验，比较治疗组与最佳支持治疗，并仔细分析生活质量和成本效益，以阐明二线治疗在晚期非小细胞肺癌中的作用。(C)2000爱思唯尔科学爱尔兰有限公司保留所有权利。
After a certain degree of nihilism, chemotherapy has become the standard treatment for advanced and metastatic non-small cell lung cancer (NSCLC). The new chemotherapeutic drugs (vinorelbine, taxanes, gemcitabine, and irinotecan) and their associations with cisplatin have shown better response rates and survival in comparison with the standard regimens. This increase of survival is the main motive of the possible consideration of a second-line therapy in NSCLC patients. To this regard, the most promising drug may be docetaxel that, in a randomized trial comprising a best supportive care arm (BSC), documented a response rate of 7.6%, a longer median survival (31 weeks versus 21 of BSC). and a statistically better quality life. Other phase II studies obtained a response rate of 20% and 1-year survival of 40% using docetaxel. Also gemcitabine has shown interesting results in this setting, with a 19% response rate and a median and I-year survival rate of 34 weeks and 45%, respectively. The activity of paclitaxel is not well defined because of conflicting results and deserves further investigations, while the efficacy of vinorelbine and irinotecan has been dismal. Large randomized trials comparing the treatment arm with best supportive care and a careful analysis of quality of life and cost-effectiveness will be needed to clarify the role of second-line therapy in advanced NSCLC. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.