Pacific Cancer Centre, Singapore.
Curr Drug Targets. 2010 Jan;11(1):58-60. doi: 10.2174/138945010790031036.
Despite improvements in first-line therapy for advanced NSCLC all patients with metastatic disease will progress at some point. Patients with favorable prognostic factors such as good performance status, non-squamous histology, stable weight, and perhaps female gender are more likely to receive second-line chemotherapy. Currently the United States FDA recognizes three single agents (docetaxel, erlotinib, and pemetrexed) as established for providing a benefit in patients who have experienced progression after first-line therapy. This review focus on the role of PEM in the treatment of advanced NSCLC in patients who have experienced disease progression during or after first-line therapy. The multi-targeted antifolate pemetrexed is equivalent to docetaxel for second-line therapy and with less toxicity.
尽管晚期非小细胞肺癌的一线治疗有所改善，但所有转移性疾病患者都将在某个时候进展。预后良好的因素，如良好的体能状态、非鳞状组织学、稳定的体重，以及可能的女性性别，更有可能接受二线化疗。目前，美国食品和药物管理局 (FDA) 认可三种单一药物（多西紫杉醇、厄洛替尼和培美曲塞）在一线治疗后进展的患者中提供获益。本综述重点关注培美曲塞在一线治疗期间或之后疾病进展的晚期非小细胞肺癌患者中的治疗作用。多靶点抗叶酸培美曲塞在二线治疗中与多西紫杉醇等效，且毒性更小。
