Stinchcombe Thomas E, Lee Carrie B, Socinski Mark A
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill 27599-7305, USA.
Clin Lung Cancer. 2006 May;7 Suppl 4:S111-7. doi: 10.3816/clc.2006.s.002.
Lung cancer is the leading cause of cancer-related death among men and women in the United States. Approximately 80-85% of lung cancer cases are non-small-cell lung cancer (NSCLC), and approximately 65% of these patients have advanced-stage (IIIB/IV) disease at diagnosis. The median survival for patients with advanced-stage NSCLC treated with platinum-based chemotherapy is a disappointing 8-10 months. This article reviews the current status of chemotherapy in patients with a good functional status and evaluates the treatments in terms of efficacy, toxicity, survival, and impact on quality of life in the first-line treatment. Biologic agents such as bevacizumab and erlotinib have been investigated in phase III trials in the first- and second-line setting. These agents could play a role in select patient populations. This article also highlights some of the more promising new strategies, such as advances in pharmacogenomics and immune-based therapy. There is a clear need for improvement in the current standard of care. Well-designed clinical trials with appropriate patient selection, as well as continued efforts in translational research and pharmacogenomics, are crucial for progress in this disease.
肺癌是美国男性和女性癌症相关死亡的主要原因。大约80 - 85%的肺癌病例是非小细胞肺癌（NSCLC），且这些患者中约65%在诊断时已处于晚期（IIIB/IV期）疾病状态。接受铂类化疗的晚期NSCLC患者的中位生存期令人失望，仅为8 - 10个月。本文回顾了功能状态良好的患者的化疗现状，并从疗效、毒性、生存期以及对一线治疗中生活质量的影响等方面评估了各种治疗方法。生物制剂如贝伐单抗和厄洛替尼已在一线和二线治疗的III期试验中进行了研究。这些药物可能在特定患者群体中发挥作用。本文还重点介绍了一些更有前景的新策略，如药物基因组学的进展和基于免疫的治疗。当前的治疗标准显然需要改进。精心设计的临床试验、合适的患者选择，以及在转化研究和药物基因组学方面的持续努力，对于攻克这种疾病至关重要。
