Kato Yasufumi, Saijo Nagahiro
Department of Internal Medicine, National Cancer Center Hospital, Tokyo, Japan.
Nihon Geka Gakkai Zasshi. 2002 Feb;103(2):218-23.
Platinum-based chemotherapy is considered to be the standard chemotherapy of non-small cell lung cancer (NSCLC) at present. New agents such as irinotecan, paclitaxel, docetaxel, vinorelbine, gemcitabine, topotecan, and amurubicin were developed in the 1990s. Combination chemotherapy using new agents improved survival rates compared with the classic regimen. Irinotecan, paclitaxel, docetaxel, vinorelbine, and gemcitabine have been confirmed to be effective against NSCLC. However, chemotherapy for NSCLC is controversial because the differences in the efficacies of combination chemotherapies including new agents have not been recognized in randomized controlled trials. The Four-Arms Cooperative Study is an ongoing postmarketing clinical trial in Japan. The a ntitumor agents irinotecan, topotecan, paclitaxel, and amurubicin have been confirmed to be effective in small cell lung cancer (SCLC). The combination of etoposide and cisplatin (PE) is the standard regimen for SCLC in Western countries. However, the combination of irinotecan and cisplatin (CP) resulted in higher response rates and better median survival times than PE for extensive-disease SCLC in a JCOG trial. At present, CP is considered to be the standard chemotherapy regimen to treat SCLC in Japan. The development of new agents, particularly molecular target-based drugs and multimodality treatment, is necessary to improve the therapeutic results in lung cancer further.
目前，铂类化疗被认为是非小细胞肺癌（NSCLC）的标准化疗方法。20世纪90年代开发了伊立替康、紫杉醇、多西他赛、长春瑞滨、吉西他滨、拓扑替康和阿柔比星等新型药物。与传统方案相比，使用新型药物的联合化疗提高了生存率。伊立替康、紫杉醇、多西他赛、长春瑞滨和吉西他滨已被证实对NSCLC有效。然而，NSCLC的化疗存在争议，因为在随机对照试验中尚未认识到包括新型药物在内的联合化疗疗效的差异。四国合作研究是日本正在进行的一项上市后临床试验。抗肿瘤药物伊立替康、拓扑替康、紫杉醇和阿柔比星已被证实在小细胞肺癌（SCLC）中有效。在西方国家，依托泊苷和顺铂联合方案（PE）是SCLC的标准治疗方案。然而，在一项日本临床肿瘤学会（JCOG）试验中，对于广泛期SCLC，伊立替康和顺铂联合方案（CP）的缓解率更高，中位生存时间更长。目前，CP被认为是日本治疗SCLC的标准化疗方案。进一步改善肺癌治疗效果需要开发新型药物，特别是基于分子靶点的药物和多模式治疗。
