Abstract
Background and Objectives: Lung cancer is the second most common cancer in the world. Non-small-cell lung carcinoma (NSCLC) makes up 85% of all lung cancer cases and the majority of patients are diagnosed when the cancer is advanced. Over the years, many anticancer drugs have been designed and introduced into the market to treat patients with advanced NSCLC. This review aims to discuss the comparative therapeutic benefits of conventional chemotherapeutics and other drugs available for treating advanced NSCLC. Materials and Methods: A literature search for first-line treatment of advanced NSCLC was carried out on PubMed and Google Scholar. Objective response rate (ORR) and overall survival were chosen as target endpoints. Results: Monotherapy showed lower treatment endpoints compared to combination therapy. Different combinations of platinum-based doublets demonstrated similar efficacies in treating NSCLC. However, pemetrexed–platinum doublets showed significantly better treatment endpoint in patients with non-squamous NSCLC. Most studies showing the best complete response rate (CRR) utilized epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI), while most studies producing the best overall survival included programmed death-1/programmed death-ligand 1 (PD-1/PD-L1) inhibitors in their treatment regimens. Conclusions: The findings of this review indicate that targeted therapy using specific inhibitors is now the most promising first-line anticancer treatment available in the market. However, chemotherapy is still effective in treating advanced NSCLC and is viable as a first-line treatment.
Highlights
Lung cancer is the second most common cancer in the world
* “Complete Response” (CR): Disappearance of all target lesions; “Partial Response” (PR): 30% or more decrease in the sum of diameter of target lesions compared to baseline diameter; “Stable Disease” (SD): Neither PR nor PD; “Progressive Disease” (PD): 20% or more increase in sum of diameter of target lesions compared to baseline diameter; “Objective response” = CR + PR [31]. ** “Performance Score” (PS): Eastern Cooperative Oncology Group (ECOG) PS, World Health Organization (WHO) PS, Karnofsky PS (KPS). *** “Overall Survival” (OS), “Median Survival Time” (MST)
* “Complete Response” (CR): Disappearance of all target lesions; “Partial Response” (PR): 30% or more decrease in the sum of diameter of target lesions compared to baseline diameter; “Stable Disease” (SD): Neither PR nor PD; “Progressive Disease” (PD): 20% or more increase in sum of diameter of target lesions compared to baseline diameter; “Objective response” = CR + PR [31]. ** “Performance Score” (PS): “Median Survival Time” (MST)
Summary
Lung cancer is the second most common cancer in the world It is the cancer with the highest mortality rate for both sexes combined. In 2020, an estimated 2.2 million new cases of lung cancer were recorded, and it was responsible for the death of 20% of cancer patients around the world [1]. More than half of the patients with lung cancer are diagnosed with advanced lung cancer when they present to doctors with symptoms for the first time and the overall five-year survival rate for lung cancer patients is approximately 20% [2,3,4].
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