First-line treatment in advanced non-small-cell lung cancer: the emerging role of the histologic subtype

Abstract

Lung cancer is the leading cause of cancer mortality worldwide. During the past quarter of a century, there have been definite steps forward in understanding the biology of this disease. However, progress in the treatment of advanced non-small-cell lung cancer (NSCLC) has been more elusive and has not been associated with a realistic probability of long-term survival. For this disease, platinum-based chemotherapy is currently the standard treatment. Numerous studies have compared various platinum doublets and have concluded that all such combinations are comparable in their clinical efficacy. Moreover, several trials evaluating different chemotherapy regimens in NSCLC have failed to document a difference based on histology. Recent evidence suggests that histology represents an important variable in the decision making. This review will discuss this new evidence in the first-line treatment of advanced NSCLC, focusing on different possible therapeutic approaches according to histologic subtype.

Keywords::

• adenocarcinoma
• bevacizumab
• cetuximab
• non-small-cell lung cancer
• pemetrexed
• squamous cell carcinoma

Financial & competing interests disclosure

Marcello Tiseo has received honoraria from Eli-Lilly and Roche. Andrea Ardizzoni has received honoraria from Eli-Lilly and Roche, had a consultant/advisory role with Eli-Lilly, Roche and Merck. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.