Division of Medical Oncology, S.G. Moscati Hospital, Avellino, Italy.
Oncology (Williston Park). 2010 Nov 30;24(13):1216-23.
First-line platinum-based doublets is established as the standard of care for advanced non-small-cell lung cancer (NSCLC). Nevertheless, in this field a plateau of effectiveness has been reached during the last years. One new area of exploration in NSCLC therapeutics lies in the use of tyrosine-kinase inhibitors (TKIs) or monoclonal antibodies (mAbs) to target vascular endothelial growth factor (VEGF) and its receptors, and epidermal growth factor receptor (EGFR). The results of randomized trials testing mAbs against VEGF (bevacizumab) and EGFR (cetuximab) are challenging the paradigm of the platinum doublets as the gold standard in advanced NSCLC. Despite the interesting results that have thus far been collected, the benefit of these new agents, both in terms of balancing between advantages and toxicity and the associated health economic burden, is modest. Here we discuss the use of bevacizumab and cetuximab, the mAbs for which the largest amount of data in the treatment of advanced NSCLC exists. However, despite our having a significant amount of data on these two mAbs, we still have much to learn: Which patients are appropriate for these treatments; for how long are the treatments beneficial, and what are the molecular and clinicalpredictors? We must continue to study these important problems in treating NSCLC.
一线含铂双药方案已确立为晚期非小细胞肺癌（NSCLC）的标准治疗方法。然而，近年来该领域的疗效已达到平台期。在 NSCLC 治疗中，新的探索领域之一是使用酪氨酸激酶抑制剂（TKIs）或单克隆抗体（mAbs）来靶向血管内皮生长因子（VEGF）及其受体和表皮生长因子受体（EGFR）。针对 VEGF（贝伐珠单抗）和 EGFR（西妥昔单抗）的 mAbs 的随机试验结果对含铂双药方案作为晚期 NSCLC 的金标准提出了挑战。尽管迄今为止已经收集到了有趣的结果，但这些新药物的益处，无论是在权衡优势和毒性以及相关的健康经济负担方面，都是适度的。在这里，我们讨论了贝伐珠单抗和西妥昔单抗的应用，这两种 mAbs 在治疗晚期 NSCLC 方面有最多的数据。然而，尽管我们对这两种 mAbs 有大量的数据，但我们仍有很多需要学习：哪些患者适合这些治疗方法；治疗的益处持续多长时间，以及哪些是分子和临床预测因素？我们必须继续研究这些在治疗 NSCLC 方面的重要问题。
