Show simple item record

dc.contributor.authorBlackhall, Fiona H
dc.contributor.authorShepherd, Frances A
dc.contributor.authorAlbain, Kathy S
dc.date.accessioned2009-07-22T08:45:23Z
dc.date.available2009-07-22T08:45:23Z
dc.date.issued2005
dc.identifier.citationImproving survival and reducing toxicity with chemotherapy in advanced non-small cell lung cancer : a realistic goal? 2005, 4 (2):71-84 Treat Respir Meden
dc.identifier.issn1176-3450
dc.identifier.pmid15813659
dc.identifier.urihttp://hdl.handle.net/10541/74876
dc.description.abstractThe role of chemotherapy in the treatment of advanced non-small cell lung cancer (NSCLC) has been debated over three decades, but it is only relatively recently that chemotherapy has become a standard of care for this disease. In addition to prolonging survival, chemotherapy can palliate distressing symptoms. Concerns that the adverse effects of chemotherapy are likely to outweigh its benefits have largely not been confirmed by quality-of-life data reported among patients with good performance status. Platinum-based chemotherapy regimens in which cisplatin or carboplatin are partnered by a third-generation cytotoxic drug such as gemcitabine, paclitaxel or vinorelbine, have similar activity and efficacy, but differ in adverse effect profiles. Response rates of 30-40% should be expected with median and 1-year survival of 8-10 months and 30-40%, respectively. In the second-line setting chemotherapy with docetaxel has been shown to be significantly superior to best supportive care alone. In a recent trial that compared docetaxel to the novel antifolate, pemetrexed the response rates and survival rates did not differ, but the toxicity profile favored pemetrexed. Overall, these data demonstrate that progress has been made in the use of chemotherapy to improve survival in patients with NSCLC without increasing the incidence of further toxicity. In the past, the potential to survive 1 year was extremely small, whereas now many more patients reach this milestone as well as the 2-year point. However, a plateau has probably been reached with existing cytotoxic drugs and there is a general belief that the next significant advance in the treatment of NSCLC will come from the addition of drugs that target specific molecular pathways in sequence with standard chemotherapy regimens.
dc.language.isoenen
dc.subjectLung Canceren
dc.subject.meshAntimetabolites, Antineoplastic
dc.subject.meshAntineoplastic Agents
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols
dc.subject.meshCarcinoma, Non-Small-Cell Lung
dc.subject.meshCisplatin
dc.subject.meshDrug Delivery Systems
dc.subject.meshHumans
dc.subject.meshLung Neoplasms
dc.subject.meshMicrotubules
dc.subject.meshQuality of Life
dc.subject.meshSurvival Analysis
dc.subject.meshTreatment Outcome
dc.subject.meshTriazines
dc.titleImproving survival and reducing toxicity with chemotherapy in advanced non-small cell lung cancer : a realistic goal?en
dc.typeArticleen
dc.contributor.departmentChristie Hospital NHS Trust, Manchester, England, United Kingdom. fiona.blackhall@christie-tr.nwest.nhs.uken
dc.identifier.journalTreatments in Respiratory Medicineen
html.description.abstractThe role of chemotherapy in the treatment of advanced non-small cell lung cancer (NSCLC) has been debated over three decades, but it is only relatively recently that chemotherapy has become a standard of care for this disease. In addition to prolonging survival, chemotherapy can palliate distressing symptoms. Concerns that the adverse effects of chemotherapy are likely to outweigh its benefits have largely not been confirmed by quality-of-life data reported among patients with good performance status. Platinum-based chemotherapy regimens in which cisplatin or carboplatin are partnered by a third-generation cytotoxic drug such as gemcitabine, paclitaxel or vinorelbine, have similar activity and efficacy, but differ in adverse effect profiles. Response rates of 30-40% should be expected with median and 1-year survival of 8-10 months and 30-40%, respectively. In the second-line setting chemotherapy with docetaxel has been shown to be significantly superior to best supportive care alone. In a recent trial that compared docetaxel to the novel antifolate, pemetrexed the response rates and survival rates did not differ, but the toxicity profile favored pemetrexed. Overall, these data demonstrate that progress has been made in the use of chemotherapy to improve survival in patients with NSCLC without increasing the incidence of further toxicity. In the past, the potential to survive 1 year was extremely small, whereas now many more patients reach this milestone as well as the 2-year point. However, a plateau has probably been reached with existing cytotoxic drugs and there is a general belief that the next significant advance in the treatment of NSCLC will come from the addition of drugs that target specific molecular pathways in sequence with standard chemotherapy regimens.


This item appears in the following Collection(s)

Show simple item record