Abstract
Lung cancer has become a leading cause of cancer-related death in the world. Patient survival has improved with the introduction of new chemotherapy regimens and targeted drugs, but still, because of tumour progression or deterioration in performance status, a high percentage of patients do not receive more than one line of treatment. Given this situation, studies of maintenance therapies have begun, with results that have led to the clinical use of various drugs in a maintenance scenario. Additionally, results obtained in various clinical trials have raised the question of personalized approaches based on the clinical, pathologic, and molecular features of the cancer-not only in the initial approach, but also in the context of maintenance. Overall, the survival benefit seen with maintenance treatment has introduced a new therapy option that should be considered and discussed with patients, and (given the controversies that currently remain) chosen based on the preferences of patients and physicians.
Highlights
The understanding of lung cancer has evolved since the 1990s, with changes seen in epidemiology, diagnosis, and treatment
Analysis of trials using gefitinib or erlotinib in nsclc found that patients carrying EGFR exon 19 or 21 mutations benefited most from those agents
The West Japan Thoracic Oncology Group 0203 phase iii trial compared prolonged chemotherapy consisting of 6 cycles of a platinum doublet with a short course of 3 cycles of chemotherapy followed by gefitinib maintenance in 604 patients
Summary
The understanding of lung cancer has evolved since the 1990s, with changes seen in epidemiology, diagnosis, and treatment. Analysis of trials using gefitinib or erlotinib in nsclc found that patients carrying EGFR exon 19 or 21 mutations benefited most from those agents Such mutations are frequently associated with Asian ethnicity, female sex, non-squamous histology, and nonsmoking status, more than 40% of patients with an EGFR activating mutation lack all of those risk factors 12. Given those findings, current guidelines recommend analysis of EGFR mutations in all patients diagnosed with advanced non-squamous nsclc so that they can be offered an adapted treatment [8,13]. We focus on maintenance therapy and highlight some considerations that may facilitate clinical decisions in specific lung cancer subtypes
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
