Management of Advanced Non-small Cell Lung Cancer: Front Line Treatment

Abstract

Over the past decades, a number of systemic treatment options for incurable, advanced non-small cell lung cancer have been developed. While untreated patients with this disease typically have a median overall survival of 4.5 months, this figure has exceeded the 12-month mark in the latest randomized phase III trials. Progress in drug development, combination chemotherapy, supportive care, and better selection of patients for specific treatments have contributed to improvements in outcome. In this chapter, we will present the key data that support the use of chemotherapy and biologic agents for the first-line treatment of advanced NSCLC. The following aspects will be discussed: selection and number of chemotherapy agents, duration of therapy, use of biologic drugs (i.e., vascular endothelial growth factor and epidermal growth factor receptor inhibitors), and management of elderly and poor performance status patients.