Improving Outcomes in Advanced Lung Cancer : Maintenance therapy in non-small-cell lung carcinoma

Muhammad Furrukh, Ikram A. Burney, Shiyam Kumar, Khwaja F. Zahid, Mansour Al-Moundhri

Abstract


Systemic chemotherapy has remained the traditional treatment for metastatic non-small-cell lung carcinoma (NSCLC), enhancing survival rate at 1 year to 29%. The median survival had plateaued at around 10 months until early 2008, and in an attempt to enhance survival in advanced disease, maintenance chemotherapy trials were initiated which had recently demonstrated prolongation of survival by an additional 2–3 months in patients who had performance status (PS) 0–1 and well-preserved organ functions. Suitable patients with any degree of clinical benefit are treated with 4–6 cycles, and then one of the active agents is continued until best response, or toxicity (continued maintenance), or changed to a cross non-resistant single agent (switch maintenance). The article briefly reviews the evolution of systemic therapy and describes key randomised trials of maintenance therapy instituting chemotherapy and targeted agents in an attempt to improve outcomes in advanced metastatic NSCLC, based on certain clinical features, histology, and genetics.



Keywords


Carcinoma; Non-small-cell lung; Lung neoplasm; Maintenance chemotherapy; Molecular targeted therapy; Receptor; Epidermal growth factor; Vascular endothelial growth factor A.

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Sultan Qaboos University Medical Journal, College of Medicine and Health Sciences, Sultan Qaboos University, PO Box 35, Postal Code 123, Al-Khod, Muscat, Oman

ISSN (Print edition): 2075-051X ISSN (Internet edition): 2075-0528

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