XXXX in non-small-cell @entity2 -an old lesson new re-visited.

@entity1 @entity0 @entity4562 @entity1149 @entity2 @entity204 @entity902 @entity3866 @entity34
@entity1149 ( @entity1149 ) accounts for approximately 80-85% of all cases of @entity2 , and it is the most common cause of @entity204 in @entity1 and second only to @entity0 in @entity1 . Combination chemotherapy, usually @entity902 -based, is currently the first-line therapy of choice, however, the prognosis for @entity1 with advanced @entity1149 remains poor with a median survival time of 8-11 months and a 1-year survival rate of 30%. Maintenance therapy is a treatment strategy that has been investigated extensively in @entity1149 and has been the subject of considerable recent debate. The outstanding results of the JMEN study proved that maintenance of pemetrexed significantly improved the overall survival ( @entity34 ) in advanced @entity1149 @entity1 was a proof of principle. Subsequently, the results of the SATURN study also showed a significant prolongation of progression-free survival (PFS) and @entity34 with maintenance @entity3866 compared with placebo. Despite considerable controversy, it has become an acceptable treatment paradigm and both drugs are approved for maintenance therapy of advanced @entity1149 @entity1 in Europe and the USA. In addition, several large phase III clinical trials (e.g., INFORM trial) provided evidence that maintenance therapy with @entity4562 also significantly improved PFS in @entity1149 @entity1 , with greatest PFS benefit in @entity1 harboring EGF-R mutations. However, @entity34 was unchanged. The question still remains whether the benefit of maintenance therapy for @entity1149 is best defined by PFS. Truely, PFS is the best predictor for improved @entity34 (and is independent @entity34 ), but @entity34 is acknowledged as the key clinical outcome in the treatment of advanced @entity1149 . The approval of pemetrexed and @entity3866 by the FDA and the EMEA and the promising data with @entity4562 have certainly shifted the pendulum towards maintenance therapy, however, the precise role for the treatment strategy of @entity1149 in terms of a maintenance approach is far from being clear and additional studies are warranted to further clarify this option.
