Molecularly tailored adjuvant chemotherapy for resected non-small cell lung cancer: a time for excitement and equipoise.

Azzoli CG, Park BJ, Pao W, Zakowski M, Kris MG
J Thorac Oncol. 2008 3 (1): 84-93

PMID: 18166846 · DOI:10.1097/JTO.0b013e31815efe24

In patients with previously-untreated, completely-resected pathologic stage II-III non-small cell lung cancer, 4 months of postoperative cisplatin-based chemotherapy reduces the risk of death by approximately 20%. To date, the only prospectively validated prognostic and predictive factor which can be used to guide clinical practice is pathologic stage. Higher stage patients have a worse prognosis, but derive more benefit from adjuvant chemotherapy. Numerous molecular markers are being developed with the potential to help decide which patients to treat with adjuvant chemotherapy, and which drugs to use. This paper will review the molecular markers which are having immediate impact on treatment decisions in routine practice, and which merit further study in the next generation of adjuvant chemotherapy trials.

MeSH Terms (25)

Antineoplastic Agents Biomarkers, Tumor Carcinoma, Non-Small-Cell Lung Chemotherapy, Adjuvant Cisplatin Clinical Trials as Topic Cyclin-Dependent Kinase Inhibitor p27 DNA-Binding Proteins Endonucleases Follow-Up Studies Genes, erbB-1 Humans Intracellular Signaling Peptides and Proteins Lung Neoplasms Membrane Transport Proteins Multidrug Resistance-Associated Proteins Neoplasm Staging Proto-Oncogene Proteins Proto-Oncogene Proteins p21(ras) Randomized Controlled Trials as Topic ras Proteins Survival Analysis Time Factors Treatment Outcome Tubulin

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