Role of adjuvant chemotherapy in the treatment of non-small-cell lung cancer

Lindsey Wilhelm; Jill M Kolesar

doi:10.2146/ajhp040529

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Role of adjuvant chemotherapy in the treatment of non-small-cell lung cancer

Journal article

Peer reviewed

Role of adjuvant chemotherapy in the treatment of non-small-cell lung cancer

Lindsey Wilhelm and Jill M Kolesar

American journal of health-system pharmacy, Vol.62(13), pp.1365-1369

07/01/2005

DOI: 10.2146/ajhp040529

PMID: 15972378

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Abstract

The role of adjuvant chemotherapy in the treatment of non-small-cell lung cancer (NSCLC) is described. The intrinsic resistance of NSCLC tumors to chemotherapy necessitates the use of complete surgical resection of the malignant growth as the primary modality of treatment; however, only about one third of patients are appropriate candidates for surgical resection. While several cytotoxic combinations have been used to treat metastatic NSCLC, no single regimen is considered the standard of care. Given the poor prognosis of patients with NSCLC, adjuvant chemotherapy has been investigated as a treatment option but has not demonstrated a consistent survival benefit. Several recent studies have sought to clarify the role of adjuvant chemotherapy in the treatment of NSCLC: the Big Lung Trial, the International Adjuvant Lung Cancer Trial (IALT), the Adjuvant Lung Project Italy trial, and a study of the combination of uracil and tegafur, which is not yet available in the United States. The IALT, the largest trial among the four and sufficiently powered to detect a survival benefit, revealed a modest increase in survival. Complicating the issue is the financial cost of adjuvant therapy, especially in light of the small survival benefit gained. The use of adjuvant chemotherapy in patients with NSCLC can lead to a modest increase in survival. Platinum-based regimens are the most studied and should be considered the regimens of choice. However, further studies are needed to determine the optimal regimen and patient population that would derive the most benefit from this treatment.

Antineoplastic Combined Chemotherapy Protocols - therapeutic use

Carcinoma, Non-Small-Cell Lung - drug therapy

Carcinoma, Non-Small-Cell Lung - pathology

Chemotherapy, Adjuvant

Cisplatin - administration & dosage

Drug Resistance, Neoplasm

Humans

Lung Neoplasms - drug therapy

Lung Neoplasms - pathology

Neoplasm Metastasis - drug therapy

Survival Rate

Tegafur - administration & dosage

United States

Uracil - administration & dosage

Details

Title: Subtitle: Role of adjuvant chemotherapy in the treatment of non-small-cell lung cancer
Creators: Lindsey Wilhelm - University of Wisconsin–Madison
Jill M Kolesar - University of Wisconsin–Madison
Resource Type: Journal article
Publication Details: American journal of health-system pharmacy, Vol.62(13), pp.1365-1369
DOI: 10.2146/ajhp040529
PMID: 15972378
ISSN: 1079-2082
eISSN: 1535-2900
Language: English
Date published: 07/01/2005
Academic Unit: Pharmacy; Pharmaceutical Sciences and Experimental Therapeutics
Record Identifier: 9984696551102771

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