Chemotherapy used to be the only available option to fight advanced nonsmall cell lung cancer. Platinum-based medication combined with taxanes, vinca alkaloids, and antimetabolites improved patient survival rates. Unfortunately, neoplasmatic diseases remain a global killer because chemotherapy benefits have reached a plateau and most patients are diagnosed at the metastatic stage. The urgent need for therapeutic agents, along with advances in the knowledge of the molecular events of oncogenesis, has resulted in the development of medication that specifically targets processes and pathways critical for tumor growth, such as angiogenesis and the epidermal growth factor receptor. Initially, inhibiting these pathways managed to prolong patient survival, although not to the extent desired. Moreover, targeted therapy combined with conventional cytotoxic agents has shown no superiority to chemotherapy alone in terms of patient survival. Hence, numerous multidynamic agents have appeared in the hope that they might help fight nonsmall cell lung cancer. However, no group of patients who will hopefully gain maximum benefit from such interventions has been clearly identified yet. This paper presents current evidence with regard to such novel agents and angiogenesis and epidermal growth factor inhibitors.
aOncology Unit, Third Department of Medicine, Athens School of Medicine, Sotiria General Hospital, Athens, Greece
bDepartment of Medical Oncology, Yale School of Medicine, New Haven, USA
Correspondence to Elias A. Kotteas, MD, Athens University School of Medicine, Oncology Unit, Third Department of Medicine, Sotiria General Hospital, Building Z, 152 Messogeion Avenue, 115 27 Athens, Greece
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Received 30 June 2009 Revised form accepted 2 November 2009