TY - JOUR
T1 - Adjuvant therapy for resected non-small-cell lung cancer
T2 - Recent advances, emerging agents, and lingering questions
AU - Lin, Tara L.
AU - Brahmer, Julie R.
N1 - Funding Information:
Targeted therapies interrupt cell signaling or biologic pathways to exert an antineoplastic effect. They may have a role as single agents or in combination with chemotherapy. Examples of targeted therapies include epidermal growth factor receptor inhibitors, signal transduction inhibitors, apoptosis inducers, and eicosanoid pathway inhibitors [21]. Gefitinib has been approved for third-line use in locally advanced and metastatic NSCLC. Gefitinib is an inhibitor of tyrosine kinases, including those associated with the epidermal growth factor receptor (EGFR). A National Cancer Institute of Canada (NCIC)–sponsored phase III placebo-controlled trial of adjuvant gefitinib in resected stage IB, II, and IIIA NSCLC is currently accruing patients [22]. In addition to targeted therapies, immunotherapy is also under investigation as a means to enhance the body’s response to malignant cells. An industry-sponsored phase I study (Epim-mune, San Diego, CA) in patients with stage IIB and IIIA NSCLC is evaluating the use of a peptide vaccine following complete resection [22]. Also, p53-peptide pulsed autologous dendritic cells are given to resected patients in a current phase II trial sponsored by the National Cancer Institute of the US National Institutes of Health (NCI) [22].
PY - 2004/7
Y1 - 2004/7
N2 - Survival rates for all stages of non - small-cell lung cancer (NSCLC) are dismal. Despite complete resection of early-stage NSCLC, many patients have recurrence at distant metastatic sites, reinforcing the need for effective systemic adjuvant therapy. Chemotherapy, and more recently, targeted therapies, have been evaluated in the adjuvant setting. Although initial trials did not suggest improved survival, a 1995 meta-analysis favored adjuvant cisplatin-based chemotherapy. The recently published International Adjuvant Lung Trial confirms this finding and suggests a new standard of care. In this paper we review data on adjuvant chemotherapy and limitations of recent clinical trials, including those with targeted therapies. We also address the most effective and least toxic regimens for adjuvant chemotherapy and the subsets of patients likely to derive the most benefit.
AB - Survival rates for all stages of non - small-cell lung cancer (NSCLC) are dismal. Despite complete resection of early-stage NSCLC, many patients have recurrence at distant metastatic sites, reinforcing the need for effective systemic adjuvant therapy. Chemotherapy, and more recently, targeted therapies, have been evaluated in the adjuvant setting. Although initial trials did not suggest improved survival, a 1995 meta-analysis favored adjuvant cisplatin-based chemotherapy. The recently published International Adjuvant Lung Trial confirms this finding and suggests a new standard of care. In this paper we review data on adjuvant chemotherapy and limitations of recent clinical trials, including those with targeted therapies. We also address the most effective and least toxic regimens for adjuvant chemotherapy and the subsets of patients likely to derive the most benefit.
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U2 - 10.1007/s11912-004-0032-3
DO - 10.1007/s11912-004-0032-3
M3 - Review article
C2 - 15161575
AN - SCOPUS:5444271970
SN - 1523-3790
VL - 6
SP - 251
EP - 258
JO - Current oncology reports
JF - Current oncology reports
IS - 4
ER -