Chemotherapy in metastatic and locally advanced non‐small cell lung cancer

Abstract

The majority of patients with non-small cell lung cancer have locally advanced and metastatic disease at diagnosis. Combination platinum-based chemotherapy is the standard treatment for patients with advanced disease who have a performance status of 0-1. Chemotherapy is superior to supportive care alone in terms of survival, palliation of symptoms, and in many studies, improving quality of life. Newer third generation therapies such as paclitaxel, docetaxel, vinorelbine, and gemcitabine have been proven effective as single agents with minimal toxicity, compared with supportive care alone. In combination with platinum, these agents produce higher response rates than older platinum-based regimens, are associated with additional survival benefits, and are generally more convenient and less toxic for patients. Newer nonplatinum doublets appear equivalent to newer platinum-regimens and have expanded the options available for patients. Targeted agents are promising and may soon offer patients more effective and less toxic therapies. Progress in treatment in the advanced setting has led to advances in the care of locally advanced disease. Combination chemoradiotherapy is a standard treatment for locally advanced disease, and studies with newer agents are in progress.

Clinical comparative investigation of efficacy and toxicity of cisplatin plus gemcitabine or plus Abraxane as first-line chemotherapy for stage III/IV non-small-cell lung cancer

“…In recent years, a number of studies have confirmed that chemotherapy can prolong the survival of advanced non-small-cell carcinoma and improve the quality of life compared with the best supportive treatments. 4 , 5 , 7 , 11 , 14 , 15 In order to improve the effectiveness of chemotherapy, the domestic and overseas scholars have made a lot of clinical researches. At present, platinum-based regimen is used as a standard regimen for advanced NSCLC.…”

Radiation dose and survival of patients with stage IV non-small cell lung cancer undergoing concurrent chemotherapy and thoracic three-dimensional radiotherapy: reanalysis of the findings of a single-center prospective study

“…In patients with stage IV NSCLC, four to six cycles of platinum-based combination chemotherapy typically results in 1-year survival rates of approximately 30%–45%, median time to progression of 3–5 months, and median survival time of 8–10 months [1,7,15-17]. However, uncontrolled primary tumor progression, which adversely affects survival, occurs in approximately 50% of all patients [18].…”

Impact of Accompanying Comorbidities on Survival in Patients with Stage IIIB- IV Non-Small-Cell Lung Cancer

“…Even in patients diagnosed at earlier stages, distant metastases develop in 40-70% of cases during the course of the disease in spite of surgical resection. 2 In advanced stage NSCLC, the initial therapy involves systemic treatment and radiotherapy in selected cases. Surgery is performed only if necessary and for palliative reasons.…”