Department of Medicine I, Medical University of Vienna, Vienna, Austria.
Curr Opin Oncol. 2014 Mar;26(2):145-51. doi: 10.1097/CCO.0000000000000056.
Important therapeutic advances for patients with advanced non-small-cell lung cancer (NSCLC) with focus on individualized therapy have recently occurred and are summarized in this review.
Cetuximab added to first-line chemotherapy has been shown to improve survival in patients with high epidermal growth factor receptor (EGFR) expression in their tumors. Afatinib has shown improved progression-free survival and better quality of life compared to chemotherapy in patients with EGFR-mutation-positive adenocarcinomas. Several other EGFR-directed agents are in clinical development. Crizotinib improved progression-free survival compared to second-line chemotherapy with docetaxel or pemetrexed in patients with advanced anaplastic lymphoma kinase-positive NSCLC. Selumetinib added to docetaxel has improved outcome compared with docetaxel in a randomized phase II trial in patients with advanced KRAS-mutant NSCLC and this combination is currently studied in a phase III trial. Nintedanib added to docetaxel improved progression-free survival in the second-line therapy of patients with advanced NSCLC but many other angiogenesis inhibitors failed to improve clinical outcome in phase III trials. Several other targeted therapies are currently evaluated in phase III trials in patients with advanced NSCLC.
Recent trials have led to the approval of afatinib and crizotinib for subsets of patients with advanced NSCLC.
近期在晚期非小细胞肺癌（NSCLC）患者的个体化治疗方面取得了重要的治疗进展，本综述对此进行了总结。
表皮生长因子受体（EGFR）高表达的患者，在一线化疗中加入西妥昔单抗可提高生存率。阿法替尼与化疗相比，可改善 EGFR 突变阳性腺癌患者的无进展生存期和生活质量。其他几种 EGFR 靶向药物正在临床开发中。克唑替尼与二线化疗（多西他赛或培美曲塞）相比，可改善晚期间变性淋巴瘤激酶阳性 NSCLC 患者的无进展生存期。在一项晚期 KRAS 突变 NSCLC 患者的随机 II 期试验中，西妥昔单抗联合色瑞替尼可提高无进展生存期，该联合方案目前正在 III 期试验中进行研究。在二线治疗晚期 NSCLC 患者中，尼达尼布联合多西他赛可提高无进展生存期，但许多其他抗血管生成抑制剂在 III 期试验中未能改善临床结局。其他几种靶向治疗目前正在晚期 NSCLC 患者的 III 期试验中进行评估。
近期的试验导致阿法替尼和克唑替尼获批用于晚期 NSCLC 的部分患者。
