Second-line treatment of advanced non-small cell lung cancer

Cesare Gridelli, Andrea Ardizzoni, Fortunato Ciardiello, Nasser Hanna, John V. Heymach, Francesco Perrone, Rafael Rosell, Frances A. Shepherd, Nick Thatcher, Johan Vansteenkiste, Luigi De Petris, Massimo Di Maio, Filippo De Marinis

Research output: Contribution to journalArticle

57 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)430-440
Number of pages11
JournalJournal of Thoracic Oncology
Volume3
Issue number4
DOIs
StatePublished - Apr 2008

Fingerprint

Non-Small Cell Lung Carcinoma
docetaxel
Drug Therapy
Pemetrexed
Therapeutics
Biological Factors
Treatment Failure
Research
Italy
Placebos

Keywords

  • Docetaxel
  • Erlotinib
  • Non-small cell lung cancer
  • Pemetrexed
  • Second-line chemotherapy

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

Cite this

Gridelli, C., Ardizzoni, A., Ciardiello, F., Hanna, N., Heymach, J. V., Perrone, F., ... De Marinis, F. (2008). Second-line treatment of advanced non-small cell lung cancer. Journal of Thoracic Oncology, 3(4), 430-440. https://doi.org/10.1097/JTO.0b013e318168c815

Second-line treatment of advanced non-small cell lung cancer. / Gridelli, Cesare; Ardizzoni, 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.

In: Journal of Thoracic Oncology, Vol. 3, No. 4, 04.2008, p. 430-440.

Research output: Contribution to journalArticle

Gridelli, C, Ardizzoni, A, Ciardiello, F, Hanna, N, Heymach, JV, Perrone, F, Rosell, R, Shepherd, FA, Thatcher, N, Vansteenkiste, J, De Petris, L, Di Maio, M & De Marinis, F 2008, 'Second-line treatment of advanced non-small cell lung cancer', Journal of Thoracic Oncology, vol. 3, no. 4, pp. 430-440. https://doi.org/10.1097/JTO.0b013e318168c815
Gridelli C, Ardizzoni A, Ciardiello F, Hanna N, Heymach JV, Perrone F et al. Second-line treatment of advanced non-small cell lung cancer. Journal of Thoracic Oncology. 2008 Apr;3(4):430-440. https://doi.org/10.1097/JTO.0b013e318168c815
Gridelli, Cesare ; Ardizzoni, 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. / Second-line treatment of advanced non-small cell lung cancer. In: Journal of Thoracic Oncology. 2008 ; Vol. 3, No. 4. pp. 430-440.
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