Second-Line Therapy for Advanced NSCLC.
Most patients with lung cancer have non-small cell lung cancer (NSCLC) subtype and have advanced disease at the time of diagnosis. Improvements in both first-line and subsequent therapies are allowing longer survival and enhanced quality of life for these patients. The median overall survival observed in many second-line trials is approximately 9 months, and many patients receive further therapy after second-line therapy. The cytotoxic agents pemetrexed and docetaxel and the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) erlotinib and gefitinib are standard second-line therapies. For patients with EGFR mutation, a TKI is the favored second-line therapy if not already used in first-line therapy. For patients without the EGFR mutation, TKIs are an option, but many oncologists favor cytotoxic therapy. The inhibitor of the EML4/ALK fusion protein, crizotinib, has recently become a standard second-line treatment for patients with the gene rearrangement and has promise for patients with the ROS1 rearrangement.
['Weiss|Jared M|JM|', 'Stinchcombe|Thomas E|TE|']
D002289:Carcinoma, Non-Small-Cell Lung D000077143:Docetaxel D066246:ErbB Receptors D000069347:Erlotinib Hydrochloride D000077156:Gefitinib D005971:Glutamates D006147:Guanine D006801:Humans D009154:Mutation D015514:Oncogene Proteins, Fusion D000068437:Pemetrexed D047428:Protein Kinase Inhibitors D011505:Protein-Tyrosine Kinases D011518:Proto-Oncogene Proteins D016283:Proto-Oncogene Proteins p21(ras) D011799:Quinazolines D043823:Taxoids D018631:ras Proteins
Non-small cell lung cancer Pemetrexed Docetaxel Gefitinib Erlotinib, EGFR mutation, KRAS mutation, EML4/ALK rearrangement, ROS1 rearrangement MET amplification