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Multidrug Combinations for First-line Therapy of Advanced Non-small-cell Lung Cancer

Ha N Tran, Suresh S Ramalingam, , · Oncology & Hematology Review (US) · 2011

Lung cancer is a common disease with a high mortality rate. Non-small-cell lung cancer (NSCLC), which accounts for almost 85% of all cases of lung cancer, is often diagnosed at an advanced stage. Platinum-based two-drug combination regimens have become the standard of care and should be considered in patients with a good performance status (Eastern Cooperative Oncology Group performance status scale 0–1). The addition of a third chemotherapy agent is not recommended, since there is additional toxicity without a definite survival benefit. In recent years, histology has emerged as an important factor in treatment selection. In patients with non-squamous NSCLC, the cisplatin–pemetrexed regimen has demonstrated superiority over cisplatin–gemcitabine and has emerged as a preferred regimen for this subset of patients. The addition of targeted agents such as bevacizumab or cetuximab to platinum doublets has also demonstrated modest improvements in overall survival for firstline therapy of advanced NSCLC. The identification of patient-selection methods for the use of these agents remains a major challenge. Recently, the use of maintenance therapy has emerged as an option for patients who c

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