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Semin Respir Crit Care Med 2005; 26(3): 304-313
DOI: 10.1055/s-2005-871989
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Chemotherapy in Advanced Non-Small Cell Lung Cancer

Tracey Evans1
  • 1Department of Internal Medicine, Hematology/Oncology Division, University of Pennsylvania, Philadelphia, Pennsylvania
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Publication History

Publication Date:
29 June 2005 (online)

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ABSTRACT

Although patients with advanced non-small cell lung cancer (NSCLC) cannot be cured, cytotoxic chemotherapy in patients with reasonable performance status can improve overall survival and quality of life. No one regimen has demonstrated superior efficacy results, and platinum-based doublets remain the current standard of care. The toxicity profiles of acceptable regimens differ, allowing treatment to be tailored to a specific patient. The duration of first-line chemotherapy should not exceed four to six cycles. Second- and third-line treatment regimens also have established survival benefits, which has led to increasing improvements in overall survival for patients with advanced NSCLC. Treatment approaches in patients with borderline performance status remain controversial. Although the optimal treatment approach for elderly patients has not yet been established, it is clear that the elderly do benefit from chemotherapy, and fit elderly patients can be treated with the same regimens as younger patients. It is critical that all patients with advanced NSCLC be referred to medical oncologists. Patients considering chemotherapy must have a clear understanding of the expected benefits, limitations, and toxicities.

KEYWORDS

Chemotherapy - advanced non-small cell lung cancer

REFERENCES

1 Excluding the rare patient with oligometastatic disease, or a solitary metastasis in the brain or adrenal gland, who can be approached with curative intent.

2 PS 3 patients were included in the randomized study that established the survival advantage or erlotinib over best supportive care.

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Tracey EvansM.D. 

Department of Internal Medicine, Hematology/Oncology Division

University of Pennsylvania, 103 Medical Arts Bldg., 39th and Market Sts.

Philadelphia, PA 19104

Email: tracey.evans@uphs.upenn.edu

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