Treatment Paradigms in Advanced Non–Small-Cell Lung Cancer Caroline E. McCoach, MD, PhD, and Karen Kelly, MD Dr McCoach is a clinical research fellow Abstract: Lung cancer is the most common cause of cancer-relat- and Dr Kelly is a professor of medicine, ed death worldwide, owing to its metastatic spread at the time of an associate director for clinical research, diagnosis. As a result, chemotherapy is the standard of care for the and the Jennifer Rene Harmon Tegley majority of patients. In recent years, the role of chemotherapy has and Elizabeth Erica Harmon Endowed Chair in Cancer Clinical Research in the expanded to include maintenance therapy and approved second- department of internal medicine at the and third-line treatments. Nonetheless, traditional chemotherapy University of California, Davis Medical has modestly improved outcomes in patients with advanced Center in Sacramento, California. non–small-cell lung cancer (NSCLC). Research efforts have been redirected toward the integration of molecularly-targeted agents Address correspondence to: into a treatment algorithm with unprecedented survival rates Karen Kelly, MD UC Davis Comprehensive Cancer Center in selected patients. This article will provide an update on the 4501 X Street, Suite 3016 multiple systemic regimens available to treat NSCLC, and discuss Sacramento, CA 95817 emerging molecular-based therapies. Phone: 916-734-3735 Fax: 916-734-7946 E-mail:
[email protected] Introduction Lung cancer is the leading cause of cancer-related death worldwide, contributing to an estimated 1.4 million deaths every year.1 This high mortality rate results from the inability to detect lung cancer in its early stage.