Systemic chemotherapy for advanced non-small cell lung cancer: Recent advances and future directions
Systemic chemotherapy for advanced non-small cell lung cancer: Recent advances and future directions
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DOI：
10.1634/theoncologist.13-s1-5
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发表时间：
2008-01-01
期刊：
影响因子：
5.8
通讯作者：
Belani, Chandra
中科院分区：
文献类型：
--
作者：
Ramalingam, Suresh;Belani, Chandra
全身治疗可提高晚期非小细胞肺癌（NSCLC）患者的生存率和生活质量。晚期NSCLC出现了几种新的治疗选择，包括新型细胞毒性药物（紫杉烷类、吉西他滨、培美曲塞）和分子靶向药物（厄洛替尼、贝伐珠单抗）。改善晚期和转移性NSCLC一线治疗结局的努力主要集中在以铂为基础的两药方案中添加靶向药物。贝伐单抗是一种抗血管内皮生长因子的抗体，是第一种在晚期疾病中加入全身化疗后显示出上级疗效的药物。目前正在评估一线联合化疗4 - 6个周期后维持治疗的作用。细胞毒性药物和靶向药物均适合在维持治疗环境中进行评价。在卡铂和紫杉醇联合治疗4个周期后，单药紫杉醇作为维持治疗的结果令人鼓舞。目前正在进行III期研究，以评估吉西他滨、培美曲塞和厄洛替尼作为维持治疗在4个周期联合化疗后出现缓解或疾病稳定的患者的作用。这种方法是否能成功地延长一组选定患者的生存期还有待观察。
Systemic therapy improves the survival and quality of life of patients with advanced stage non-small cell lung cancer (NSCLC). Several new therapeutic options have emerged for advanced NSCLC, incorporating novel cytotoxic agents (taxanes, gemcitabine, pemetrexed) and molecular-targeted agents (erlotinib, bevacizumab). Efforts to improve the outcome of first-line therapy for advanced and metastatic NSCLC have primarily focused on the addition of targeted agents to platinum-based two-drug regimens. Bevacizumab, an antibody against vascular endothelial growth factor, is the first drug to demonstrate superior outcomes when added to systemic chemotherapy in advanced disease. Evaluation of the role of maintenance therapy following four to six cycles of first-line combination chemotherapy is ongoing. Both cytotoxic agents and targeted agents are suitable for evaluation in the maintenance setting. Promising results have been noted with single-agent paclitaxel as maintenance therapy following four cycles of combination therapy with carboplatin and paclitaxel. Phase III studies are now under way to evaluate the roles of gemcitabine, pemetrexed, and erlotinib as maintenance therapies for patients who experience a response or disease stabilization after four cycles of combination chemotherapy. Whether this approach will be successful in extending the survival of a select group of patients remains to be seen.