Authors
Gridelli, CesareArdizzoni, Andrea
Ciardiello, Fortunato
Hanna, Nasser
Heymach, John V
Perrone, Francesco
Rosell, Rafael
Shepherd, Frances A
Thatcher, Nick
Vansteenkiste, Johan
De Petris, Luigi
Di Maio, Massimo
De Marinis, Filippo
Affiliation
Medical Oncology, "S.G. Moscati" Hospital, Avellino, Italy. cgridelli@libero.itIssue Date
2008-04
Metadata
Show full item recordAbstract
After failure of first-line chemotherapy for advanced non-small cell lung cancer, many patients remain candidates to receive further antitumor treatment. To guide clinical management of these patients and to suggest priorities for clinical research, an International Panel of Experts met in Naples (Italy) in April 2007. Results and evidence-based conclusions are presented in this article. Single-agent chemotherapy with docetaxel or pemetrexed is the recommended option for unselected patients with performance status 0 to 2 who are candidates for second-line chemotherapy for advanced non-small cell lung cancer. Docetaxel has demonstrated superiority compared with best supportive care. Pemetrexed has been shown to be noninferior to docetaxel, with a more favorable toxicity profile. Erlotinib is effective in pretreated patients, and can be given second-line in patients not suitable or intolerant to chemotherapy, and in all patients as third-line treatment after failure of second-line chemotherapy. Gefitinib failed to show superiority to placebo as second- or third-line treatment, but it has been shown to be noninferior to docetaxel. In selected patients such as lifetime nonsmokers or those of East-Asian ethnicity, erlotinib, or gefitinib (where licensed) may be considered as second-line treatment even if they are fit for chemotherapy. Best supportive care in addition to active treatment remains important for all patients, but may be the exclusive option for patients unsuitable for more aggressive therapy. Further research is mandatory, to find better treatments, and to identify clinical and molecular predictive markers of efficacy, both for chemotherapy and for novel biologic agents.Citation
Second-line treatment of advanced non-small cell lung cancer. 2008, 3 (4):430-40 J Thorac OncolJournal
Journal of Thoracic OncologyDOI
10.1097/JTO.0b013e318168c815PubMed ID
18379366Type
ArticleLanguage
enISSN
1556-1380ae974a485f413a2113503eed53cd6c53
10.1097/JTO.0b013e318168c815
Scopus Count
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