Advances in the treatment of metastatic non-small-cell lung cancer with chemotherapy and targeted agents

Abstract

The treatment of non-small-cell lung cancer (NSCLC) is constantly evolving. Recent advances in both the front-line and relapsed/refractory setting have improved patient outcome, whereas in the past, best supportive care was considered the only viable option for patients with advanced or metastatic NSCLC. Improvements in chemotherapeutic regimens and the development of novel targeted agents have resulted in incremental improvements in overall patient survival. The antiangiogenic agent bevacizumab has recently yielded a clinically significant improvement in response rate, progression-free survival, and overall survival for patients with previously untreated nonsquamous recurrent or advanced (stage IIIB/IV) metastatic NSCLC. In the second- and third-line settings, docetaxel, pemetrexed, and inhibitors of the epidermal growth factor receptor, such as erlotinib, have contributed to increased overall time to progression and overall survival. Ongoing clinical trials are currently focusing on generating further improvements in patient outcome by combining novel targeted agents and redefining patient selection criteria to enrich the population that will ultimately receive the optimal therapy for maximal benefit. © 2008 by Lippincott Williams & Wilkins.