Vol 5, No 1 (2009)
Review paper
Published online: 2009-02-02
Second-line treatment in non-small cell lung cancer
Onkol. Prak. Klin 2009;5(1):1-8.
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.
Keywords: non-small-cell lung cancersecond-line therapychemotherapytargeted therapy
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