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Vol 5, No 1 (2009)
Review paper
Published online: 2009-02-02
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Second-line treatment in non-small cell lung cancer

Maciej Krzakowski
Onkol. Prak. Klin 2009;5(1):1-8.

open access

Vol 5, No 1 (2009)
REVIEW ARTICLES
Published online: 2009-02-02

Abstract

Approximately 50% of patients with advanced non-small-cell lung cancer (NSCLC) may achieve clinical benefit with first-line platinum-based chemotherapy, but nearly all of them develop progressive disease. At this stage, some patients may still have an adequate performance status and they are considered for active treatment. Second-line monotherapy with docetaxel or pemetrexed is a therapeutic option and in carefully selected patients it may produce temporary symptom relief as well as modest life prolongation compared to survival time achieved with active symptomatic care alone. Erlotinib - small-molecule tyrosine kinase inhibitor - is also effective in chemotherapy-pretreated patients with advanced NSCLC and may be used as second-line therapy in patients not suitable or intolerant to cytoxic agents or as third-line therapy after failure of second-line chemotherapy. Best supportive care is still a valid option for patients with poor performance status. A number of questions concerning second-line therapy in patients with advanced NSCLC remain to be answered (eg, optimal duration, rechallenge with agents used in first-line, optimal use of targeted therapies) and further clinical research is mandatory to improve outcome of patients.

Abstract

Approximately 50% of patients with advanced non-small-cell lung cancer (NSCLC) may achieve clinical benefit with first-line platinum-based chemotherapy, but nearly all of them develop progressive disease. At this stage, some patients may still have an adequate performance status and they are considered for active treatment. Second-line monotherapy with docetaxel or pemetrexed is a therapeutic option and in carefully selected patients it may produce temporary symptom relief as well as modest life prolongation compared to survival time achieved with active symptomatic care alone. Erlotinib - small-molecule tyrosine kinase inhibitor - is also effective in chemotherapy-pretreated patients with advanced NSCLC and may be used as second-line therapy in patients not suitable or intolerant to cytoxic agents or as third-line therapy after failure of second-line chemotherapy. Best supportive care is still a valid option for patients with poor performance status. A number of questions concerning second-line therapy in patients with advanced NSCLC remain to be answered (eg, optimal duration, rechallenge with agents used in first-line, optimal use of targeted therapies) and further clinical research is mandatory to improve outcome of patients.
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Keywords

non-small-cell lung cancer; second-line therapy; chemotherapy; targeted therapy

About this article
Title

Second-line treatment in non-small cell lung cancer

Journal

Oncology in Clinical Practice

Issue

Vol 5, No 1 (2009)

Article type

Review paper

Pages

1-8

Published online

2009-02-02

Bibliographic record

Onkol. Prak. Klin 2009;5(1):1-8.

Keywords

non-small-cell lung cancer
second-line therapy
chemotherapy
targeted therapy

Authors

Maciej Krzakowski

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