Korean J Med.  2009 Jul;77(1):9-17.

Targeted therapy and tailored chemotherapy for advanced non-small cell lung cancer

Affiliations
  • 1Center for Lung Cancer, Hematology-Oncology Clinic, Center for Specific Organs Cancer, National Cancer Center, Seoul, Korea.

Abstract

The prognosis of advanced non-small cell lung cancer (NSCLC) is very poor and the median overall survival is 10 to 12 months, despite the use of chemotherapy and targeted therapy. Recently, many targeted agents for NSCLC have been developed and tested in clinical trials. Of these, chemotherapeutic agents targeting epidermal growth factor receptor (EGFR), such as gefitinib, erlotinib and cetuximab, have been very efficacious in the treatment of NSCLC. Many phase III trials have evaluated the efficacy of these agents in combination with cytotoxic chemotherapy. Based on the results of these trials, clinical and molecular predictors of the response to EGFR-targeted agents, such as EGFR mutations or gene amplification, have been elucidated. Recent advances in understanding the biologic basis of acquired resistance to these agents have potential to improve the clinical effectiveness of agents targeting EGFR. Another agent, bevacizumab, targets an angiogenesis inhibitor, and has improved the survival in advanced NSCLC when used in combination with chemotherapy. In addition, many agents targeting tyrosine kinase inhibitors are being used in clinical trials. This review summarizes the outcomes of clinical trials evaluating agents targeting EGFR, angiogenesis inhibitors, and other molecules used alone or in combination with chemotherapy for the treatment of advanced NSCLC. Also, the predictive role of NSCLC histology for chemotherapy response will be summarized from the results of phase III studies.

Keyword

Non-small cell lung cancer; Molecular targeted agents; Epidermal growth factor receptor; Angiogenesis inhibitor

MeSH Terms

Angiogenesis Inhibitors
Antibodies, Monoclonal, Humanized
Carcinoma, Non-Small-Cell Lung
Gene Amplification
Prognosis
Protein-Tyrosine Kinases
Quinazolines
Receptor, Epidermal Growth Factor
Bevacizumab
Cetuximab
Erlotinib Hydrochloride
Angiogenesis Inhibitors
Antibodies, Monoclonal, Humanized
Protein-Tyrosine Kinases
Quinazolines
Receptor, Epidermal Growth Factor
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