Quoix E
Service de Pneumologie, Hôpitaux Universitaires de Strasbourg, 1 place de l'Hôpital, Strasbourg cedex, France.
Rev Mal Respir. 2008 Oct;25(8 Pt 2):3S113-8.
Second line chemotherapy for advanced non small cell lung cancer is a recent concept as the first phase III studies demonstrating its efficacy were published in 2000. Docetaxel was the first agent explored and deemed efficient in this setting at the dose of 75 mg/m2 every 3 weeks. Then pemetrexed was compared to docetaxel in a non-inferiority randomized trial at the dose of 500 mg/m2 every 3 weeks and demonstrated similar efficacy with significantly less toxicity than docetaxel. Targeted therapies undergo exponential development in the treatment of non-small cell lung cancer and the small molecule erlotinib (at a dose of 150 mg/day per os) which inhibits the tyrosine kinase of EGF-R demonstrated a significant benefit of survival compared to placebo in second or third line of chemotherapy. At this time there is no specific recommendations for further lines of chemotherapy although in clinical practice, they are currently used in good performance status patients.
晚期非小细胞肺癌的二线化疗是一个较新的概念，因为首批证明其疗效的III期研究于2000年发表。多西他赛是在此情况下首个被探索并被认为有效的药物，剂量为每3周75mg/m²。随后培美曲塞在一项非劣效性随机试验中与多西他赛进行比较，剂量为每3周500mg/m²，结果显示其疗效相似，但毒性明显低于多西他赛。在非小细胞肺癌的治疗中，靶向治疗呈指数级发展，小分子厄洛替尼（口服剂量为每日150mg）可抑制表皮生长因子受体（EGF-R）的酪氨酸激酶，在二线或三线化疗中与安慰剂相比显示出显著的生存获益。目前对于进一步的化疗线数尚无具体推荐，尽管在临床实践中，它们目前用于身体状况良好的患者。
