Future Scenarios for the Treatment of Advanced Non-Small Cell Lung Cancer: Focus on Taxane-Containing Regimens
Future Scenarios for the Treatment of Advanced Non-Small Cell Lung Cancer: Focus on Taxane-Containing Regimens
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DOI：
10.1634/theoncologist.2010-0322
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发表时间：
2010-10-01
期刊：
影响因子：
5.8
通讯作者：
Douillard, Jean-Yves
中科院分区：
文献类型：
--
作者：
Grossi, Francesco;Kubota, Kaoru;Douillard, Jean-Yves
尽管最近在开发新的分子靶向药物方面取得了进展，但在上个世纪末被认为是标准的化疗方案，即由顺铂或卡铂加上第三代药物（多西他赛、紫杉醇、吉西他滨或长春瑞滨）组成的双药联合仍然是晚期非小细胞肺癌（NSCLC）患者的主要治疗选择。最近，对现有标准治疗进行了修订，以反映顺铂-培美曲塞作为非鳞状NSCLC一线治疗相比顺铂-吉西他滨具有显著的生存优势。添加生物药物（贝伐单抗，西妥昔单抗）或使用单药表皮生长因子受体抑制剂可能会进一步改善选定患者的结局。主要通过最近的荟萃分析越来越清楚地表明，尽管铂类药物联合吉西他滨、长春瑞滨、多西他赛或紫杉醇的治疗等效性已被长期接受，但每种方案的副作用和治疗结局不同，因此临床医生可以为未经化疗的IIIB/IV期NSCLC患者选择最合适的治疗方法。在这篇综述中，我们评估了现有的证据，并探讨了各种现代化疗方案的作用和重要性，目的是优化治疗选择和生物制剂的组合。重点放在紫杉烷类（多西他赛与紫杉醇）在这一不断变化的景观中的作用。肿瘤学家2010;15：1102-1112
Despite recent progress in the development of new molecularly targeted agents, the chemotherapy regimens considered standard at the end of the last century that is, two-drug combinations consisting of either cisplatin or carboplatin plus a third-generation agent (docetaxel, paclitaxel, gemcitabine, or vinorelbine) remain the primary treatment option for advanced non-small cell lung cancer (NSCLC) patients. Most recently, the existing standard of care has been amended to reflect the significant survival advantage of cisplatin-pemetrexed over cisplatin-gemcitabine as first-line treatment of nonsquamous NSCLC. The addition of a biological drug (bevacizumab, cetuximab) or the use of a single-agent epidermal growth factor receptor inhibitor may further improve outcomes in selected patients. It has become increasingly clear, primarily through recent meta-analyses, that although the therapeutic equivalence of any combination of a platinum agent plus either gemcitabine, vinorelbine, docetaxel, or paclitaxel has been long accepted, each regimen has different side effects and therapeutic outcomes that allow clinicians to select the most appropriate treatment for chemotherapy-naive patients with stage IIIB/IV NSCLC. In this review, we evaluate the available evidence and explore the role and importance of various modern chemotherapy regimens, with the aim of optimizing treatment selection and combination with biological agents. Emphasis is placed on the role of taxanes (docetaxel versus paclitaxel) in this changing landscape. The Oncologist 2010;15: 1102-1112