Medical management of lung cancer: Experience in China.

Abstract

Lung cancer is the leading cause of death from cancer worldwide, as well as in China. A multidisciplinary treatment strategy for lung cancer, which includes medical and radiation oncology, surgery, and pathology is used in clinical practice in China. Chinese lung cancer patients are treated according to different pathologic and genetic types of the disease. For those with active epidermal growth factor receptor (EGFR) mutation, EGFR tyrosine kinase inhibitors (EGFR-TKIs) are used in first-, second- or third-line and maintenance treatment of non-small cell lung cancer (NSCLC). For patients with anaplastic lymphoma kinase (ALK) gene rearrangement, Crizotinib is a promising treatment in advanced NSCLC patients. A platinum-based regimen remains the mainstay of first-line systemic therapy for advanced NSCLC patients who are negative for EGFR mutation or ALK gene rearrangement. For patients with non-squamous NSCLC, Pemetrexed plus Cisplatin is recommended in first-line systemic therapy. An Endostatin combination with chemotherapy is used in first- and second-line advanced NSCLC patients. S-1 presents a new option of chemotherapy in advanced NSCLC cases. Cisplatin-based doublet chemotherapy is commonly used in NSCLC patients after surgery as adjuvant therapy. EGFR-TKIs are now being assessed in the adjuvant setting. The standard first-line chemotherapy regimen of small cell lung cancer (SCLC) is platinum with Etoposide (PE). Amrubicin provides similar survival compared with the PE regimen with an acceptable toxicity profile in extensive stage SCLC patients. Supportive care, such as traditional Chinese medicine and pegylated filgrastim, play an important role in improving patients' quality of life.