NSCLC

Gefitinib (Iressa) TKI EGFR Inhibition of kinase activity - ATP-competitive NSCLC... 

Bevacizumab (Avastin) Humanized antibody, lgG1 VEGF Inhibition of ligand binding CRC NSCLC... 

There are four major histologic types of lung cancer that are divided into two classes based on response to treatment and prognosis small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). However, it is important to note that certain other rare malignancies can be seen as well as mixed-type carcinomas. The four major types of lung cancer are outlined in Table 87-1. 

What is the estimated survival time for this stage of NSCLC ... 

Chemo, chemotherapy NSCLC, non-small cell lung cancer PORT, postoperative radiotherapy TNM, tumor node metastasis. 

The first step in treatment of NSCLC involves confirmation of the clinical stage and determination of resectability of the tumor. This decision always should be made by a thoracic surgeon who routinely performs lung cancer surgery. Treatment options depend on the advancement of disease (i.e., local, locally advanced, or metastatic). 

Kerr C. Bevacizumab and chemotherapy improve survival in NSCLC. Lancet Oncol 2005 6(5) 266. 

Testicular cancer SCLC NSCLC ANLL KS HD NHL BMT preparative chemotherapy gastric cancer... 

Radiation therapy is the treatment of choice for chemotherapy-resistant tumors such as non-small cell lung cancer (NSCLC) or in chemotherapy-refractory patients with SVCS. Between 70% and 90% of patients will experience relief of symptoms. Radiation therapy also may be combined with chemotherapy for chemotherapy-sensitive tumors such as SCLC and lymphoma. In the rare emergency situations of airway obstruction or elevated intracranial pressure, empirical radiotherapy prior to tissue diagnosis should be used. In most patients, symptoms resolve within 1 to 3 weeks. 

Addison CL, Belperio JA, Burdick MD, Stricter RM. Overexpression of the duffy antigen receptor for chemokines (DARC) by NSCLC tumor cells results in increased tumor necrosis. BMC Cancer 2004 4(1) 28. 

Arenberg DA, Kunkel SL, Polverini PJ, et al. Interferon-gamma-inducible protein 10 (IP-10) is an angiostatic factor that inhibits human non-small cell lung cancer (NSCLC) tumorigenesis and spontaneous metastases. J Exp Med 1996 184(3) 981-992. 

Lung cancer is a solid tumor originating from bronchial epithelial cells. This chapter distinguishes between non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) because they have different natural histories and responses to therapy. 

The major cell types are SCLC (-15% of all lung cancers), adenocarcinoma (-50%), squamous cell carcinoma (less than 30%), and large cell carcinoma. The last three types are grouped together and referred to as NSCLC. 

Surgery and adjuvant (postoperative) chemotherapy (Table 63-1) are the treatments of choice for early-stage NSCLC (stage I or II) some patients benefit from postoperative radiation. 

Optimal management of locally advanced NSCLC (stages IIB, IIIA, and IIIB) is controversial. Cisplatin-based doublet combinations are recommended for adjuvant and neoadjuvant (preoperative) chemotherapy, with or without concurrent radiation therapy. 

Four to six cycles of doublet chemotherapy with cisplatin or carboplatin plus docetaxel, gemcitabine, paclitaxel, or vinorelbine are recommended as first-line chemotherapy for patients with unresectable stage III or IV NSCLC. No combination was found to be superior tolerance of expected toxicities may contribute to the decision. 

Docetaxel, pemetrexed, and an oral epidermal growth factor receptor inhibitor, erlotinib, are options for unresectable stage III or IV NSCLC patients with good performance status who progress during or after first-line therapy. 

Bevacizumab, a recombinant, humanized monoclonal antibody, neutralizes vascular endothelial growth factor. The addition of bevacizumab to doublet chemotherapy is recommended in advanced NSCLC of nonsqua-mous cell histology in patients with no history of hemoptysis and no CNS metastasis who are not receiving therapeutic anticoagulation. 

Hirsh V, Desjardins P, Needles BM, Rigas JR, Jahanzeb M, Nguyen L, Zembryki D, Leopold LH (2007) Oral versus intravenous administration of vinorelbine as a single agent for the first-line treatment of metastatic nonsmall cell lung carcinoma (NSCLC) - A randomized phase II trial. American Journal of Clinical Oncology-Cancer Clinical Trials 30 245-251. 

Shepherd, F.A. et al., A randomized placebo-controlled trial of erlotinib in patients with advanced non-small cell lung cancer (NSCLC) following failure of 1st line or 2nd line chemotherapy. A National Cancer Institute of Canada Clinical Trials Croup (NCIC CTC) trial, Proc. Am. Soc. Clin. Oncol., 22(SuppL), 14S, Abstr. 7022, 2004. 

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