Targeted therapies have been largely employed in patients with advanced Non-Small Cell Lung Cancer (NSCLC), and some of them have demonstrated consistent activity. Epidermal growth factor receptor (EGFR) inhibitors, gefitinib and erlotinib, are effective in patients previously treated with chemotherapy. Responses are higher in Asians, non-smokers, females and subjects with adenocarcinoma. These findings can be explained by the substantially higher incidence of EGFR mutations in such subgroups. EGFR inhibitors in combination with first-line chemotherapy however, failed to improve survival, and better selection of patients to be offered these agents will be essential in the development of future strategies. At the same time the use of angiogenesis inhibitors as anticancer therapy has finally reached the daily practice. Vascular endothelial growth factor (VEGF) and its receptors are key regulators of the process of angiogenesis, which makes them attractive therapeutic targets. A multitude of VEGF-targeted inhibitory agents are currently being investigated for the treatment of NSCLC and a phase III study proved a significant benefit when bevacizumab was added to first-line chemotherapy in advanced NSCLC. This review focuses on the actual scenario of targeted therapies in NSCLC.
The place of targeted therapies in the management of non-small cell bronchial carcinoma. Target therapies in lung cancer management.
SCAGLIOTTI, Giorgio Vittorio;
2006-01-01
Abstract
Targeted therapies have been largely employed in patients with advanced Non-Small Cell Lung Cancer (NSCLC), and some of them have demonstrated consistent activity. Epidermal growth factor receptor (EGFR) inhibitors, gefitinib and erlotinib, are effective in patients previously treated with chemotherapy. Responses are higher in Asians, non-smokers, females and subjects with adenocarcinoma. These findings can be explained by the substantially higher incidence of EGFR mutations in such subgroups. EGFR inhibitors in combination with first-line chemotherapy however, failed to improve survival, and better selection of patients to be offered these agents will be essential in the development of future strategies. At the same time the use of angiogenesis inhibitors as anticancer therapy has finally reached the daily practice. Vascular endothelial growth factor (VEGF) and its receptors are key regulators of the process of angiogenesis, which makes them attractive therapeutic targets. A multitude of VEGF-targeted inhibitory agents are currently being investigated for the treatment of NSCLC and a phase III study proved a significant benefit when bevacizumab was added to first-line chemotherapy in advanced NSCLC. This review focuses on the actual scenario of targeted therapies in NSCLC.
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