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A Journal on Diseases of the Respiratory System
Official Journal of the Italian Society of Thoracic Endoscopy
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
SLEEP DISORDERS 2012
Minerva Pneumologica 2012 September;51(3):117-39
Treatment of metastatic non-small cell lung cancer: standard of care and future perspectives
Surmont V., Van Meerbeeck J.
Thoracic Oncology, Department of Respiratory, Medicine, Ghent University Hospital, Ghent, Belgium
The majority of patients with non-small cell lung cancer (NSCLC) present with advanced stage at diagnosis (70-80%). Platinum-based combination chemotherapy is currently the first-line therapy, however, the prognosis for patients with advanced NSCLC remains poor. New therapies focusing on the molecular mechanisms are urgently needed. As we have now a better knowledge and understanding of the biology of NSCLC, we are able to target biomarkers driving the NSCLC carcinogenesis and we can offer our patients new treatment options. This review will provide a comprehensive state of the art of treatment approaches for advanced NSCLC. This review provides an update of the major clinical trials, discusses the impact of novel therapeutics and provide future perspectives on clinical research. The evidence was collected by a systematic analysis of the literature (2000-2012) using the databases Medline (National Library of Medicine, USA), Embase (Elsevier, Netherlands), Cochrane Library (Great Britain), National Guideline Clearinghouse (USA), HTA Database (International Network of Agencies for Health Technology Assessment – INAHTA), NIH database (USA) with the following key words: metastatic NSCLC, treatment, chemotherapy, targeted agents, maintenance, review.
Despite apparent advances, for most patients with NSCLC targeted therapies have not dramatically changed outcome. The molecular complexity of lung cancer underlies these disappointments and highlights the need for optimizing treatment. Molecular profiling may allow for highly individualized treatments. Analysis of the genetic make-up of cancers is becoming more common and broad genotyping is going to become part of everyday care for lung cancer patients.