RESUMO
Systemic therapy for advanced non-small cell lung cancer (NSCLC) has evolved over the last two decades, with modest improvements in quality of life and overall survival. A plateau has been reached with traditional chemotherapy, and efforts are now being directed at developing molecularly targeted agents. To date, three such agents have been found to improve overall survival in advanced NSCLC. Erlotinib, a small-molecule inhibitor of the epidermal growth factor receptor, was approved by the US FDA in 2004 as second- or third-line treatment for advanced NSCLC. Bevacizumab, an antibody to vascular endothelial growth factor, a key mediator of angiogenesis, received approval in 2006, after a randomized trial reported a median survival of 1 year when bevacizumab was added to first-line chemotherapy. More recently, cetuximab, an antibody to the epidermal growth factor receptor, was found to improve outcome when added to chemotherapy, and FDA approval is anticipated. Several additional agents are currently being evaluated in randomized trials, with encouraging results from early studies. These and other studies are prospectively investigating predictive clinical and molecular characteristics, with the ultimate goal of individualizing therapy in advanced NSCLC.
Assuntos
Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Drogas em Investigação/uso terapêutico , Neoplasias Pulmonares/tratamento farmacológico , Anticorpos Monoclonais/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/genética , Ensaios Clínicos como Assunto , Humanos , Neoplasias Pulmonares/genética , Metanálise como Assunto , Medicina de Precisão , Terapia de Salvação , Transdução de Sinais/genética , Resultado do TratamentoRESUMO
The results of the trials presented at this year's ASCO annual meeting underline the challenges of not only treating but also studying locally advanced pancreatic cancer, with any appreciable effect of treatment gained at the cost of considerable toxicity. That response was observed in small numbers of patients in the presented trials speaks to the importance of rational selection of treatment in individual patients in order to achieve maximal survival with minimal treatment-associated morbidity. Further understanding of tumor biology and identification of both prognostic and predictive factors will help define personalized treatment approaches for individual patients.
Assuntos
Neoplasias Pancreáticas/tratamento farmacológico , Neoplasias Pancreáticas/radioterapia , Ensaios Clínicos como Assunto , Terapia Combinada , Humanos , Prognóstico , Resultado do TratamentoRESUMO
Cancer survivorship is an emerging area of scientific and clinical interest. Several decades ago, most people diagnosed with cancer did not live long beyond their initial diagnosis. Today the number of cancer survivors exceeds ten million, and this group may experience unique healthcare issues related to their cancer treatment. Chemotherapy, surgery, and radiation therapy each have their own late and long-term complications. It is imperative for clinicians who are caring for cancer survivors to be aware of long-term complications of therapy and to treat these appropriately. When cancer therapy has successfully added years of life, it is equally as important that medical care assures the best quality of life during those years.
