Cutting-edge Medical Treatment for Advanced Non-small Cell Lung Cancer - Abstract
The advent of molecular targeted drugs and effective second-line treatment for inoperable, advanced, Non-Small Cell Lung Cancer (NSCLC) has rapidly improved treatment outcomes. Conventional first-line chemotherapy regimens included all NSCLC, with the same treatment methods for squamous cell and non-squamous cell carcinomas. In addition, second-line or later treatment was not very effective in improving prognosis. However, there has been a recent paradigm shift in treatment options for NSCLC. In other words, 1) age and Performance Status (PS), 2) presence or absence of co-existing disease, 3) first-line vs. second-line or later treatment, 4) gene profiling for Epidermal Growth Factor Receptor (EGFR) gene mutations, and 5) squamous cell carcinomas vs.
non-squamous cell carcinomas have become important factors in selecting treatment regimens. Recent advances in research have shown that the presence or absence of the Echinoderm Microtubule-associated protein-Like 4 (EML4) and Anaplastic Lymphoma Kinase (ALK) fusion gene is important genetic information when considering the use of ALK inhibitors. Previously, the same regimens were selected for NSCLC regardless of
tissue type, but clinical trial results of new drugs like pemetrexed and bevacizumab have now shown that the optimal treatment method differs for squamous cell vs. nonsquamous cell carcinomas. This paper presents an overview, based on the most up-todate knowledge, on selecting treatment in lung cancer, particularly advanced NSCLC.