An Overview: Current Systemic Therapies for Advanced Non-Small Cell Lung Cancer

Michael      Ong; Mark      D. Vincent

Abstract

The paradigm of empiric treatment for advanced or metastatic non-small cell carcinoma of the lung (A-NSCLC) has been challenged in recent years, with an increasing emphasis on personalizing current therapies and utilizing new therapies that target the drivers of carcinogenesis. As more systemic therapies become available, decisions regarding the optimal type of therapy, timing and duration of treatment are becoming increasingly complex. Clinicians involved in the care of patients with lung cancer may wish to be kept up-to-date regarding the current approaches to treatment. Herein we provide an overview of the current systemic therapies for A-NSCLC, discussing evidence-based approaches to firstline, second-line and maintenance treatment. An outline of the pharmacology of the major classes of active drugs is given, and key evidence is outlined and organized by line of treatment. The characteristics of the target populations for treatment are discussed, along with the optimal combination and timing of therapy.

Keywords: Chemotherapy, bevacizumab, EGFR inhibitors, metastatic, pemetrexed, pharmacology, review, non-small cell carcinoma