Current Approaches in Chemotherapy of Advanced and Metastatic Non-small Cell Lung Cancer (NSCLC)

Abstract

Several new agents have been introduced in the palliative treatment of advanced and metastatic NSCLC in the recent years. In randomized trials, the new third-generation regimens showed comparable efficacy to each other, but a better response rate and time to progression combined with a remarkably improved tolerability compared to “classic schedules”. In patients who are not suitable for platinum-based therapy, monotherapy could be an attractive opportunity, as shown in randomized trials. In second-line therapy, the novel antifolate Pemetrexed showed comparable activity to Docetaxel with significantly reduced toxicity. Among the new oral tyrosine kinase inhibitors, Erlotinib proved to be active in second- and third-line treatments, whereas in first-line treatment, no survival benefit has been observed to date.