Non-Small-Cell Lung Cancer: Treatment of Late Stage Disease: Chemotherapeutics and New Frontiers
Non-Small-Cell Lung Cancer: Treatment of Late Stage Disease: Chemotherapeutics and New Frontiers
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DOI：
10.1055/s-0033-1342961
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发表时间：
2013-06-01
影响因子：
1.4
通讯作者：
Schneider, Bryan J.
中科院分区：
文献类型：
--
作者：
Scheff, Ronald J.;Schneider, Bryan J.
对于不再适合局部治疗的晚期非小细胞肺癌（NSCLC）患者，应考虑全身治疗。全身治疗已被证明可以提高生存率，并保持患者的生活质量，具有合理的性能状态。在原发性肝癌患者中，初始治疗的标准治疗仍然是以铂为基础的化疗。在进展时，进一步治疗通常包括单药治疗的序贯给药，这也已被证明可以改善生存率并减少癌症相关症状。分子生物标志物对于指导靶向药物是必不可少的。这种分析需要足够的肿瘤DNA;因此，足够的活检样本对于指导治疗选择至关重要。目前正在验证更多的生物标志物，并可能具有特异性靶向治疗。在不久的将来，快速多重基因型检测可能有助于减少对大量肿瘤分析的需求，并将促进个性化癌症治疗。我们回顾了IV期NSCLC定义的最新变化，并回顾了晚期疾病患者当前和未来的系统治疗方法。
Systemic therapy should be considered in patients with advanced non-small cell lung cancer (NSCLC) who are no longer amenable to local therapies. Systemic therapy has been shown to improve survival and preserve quality of life in patients with a reasonable performance status. In unselected patients, the standard of care for initial therapy remains platinum-based chemotherapy. At progression, further treatment typically consists of the sequential administration of single-agent therapy, which has also been shown to improve survival and reduce cancer-related symptoms. Molecular biomarkers are essential to guide targeted agents. This analysis requires ample tumor DNA; thus adequate biopsy samples are critical to guide therapeutic options. More biomarkers are currently being validated andmay potentially have specific targeted therapy. In the near future, it is likely that rapid multiplexed genotype testing will help reduce the need for large amounts of tumor for analysis and will promote personalized cancer therapy. We review recent changes in the definition of stage IV NSCLC and review current and future systemic therapeutic approaches for patients with advanced disease.