Advanced Lung Cancer—Reaching a Survival Ceiling with Chemotherapy, the Nibs, and the Mabs
Riccardo Lencioni, James Chen, Gordon Downie, Llew Keltner
DOI: 10.4236/jct.2011.22018   PDF    HTML     5,922 Downloads   10,516 Views   Citations

Abstract

Lung cancer is the leading cause of cancer-related death worldwide. Despite intensive research conducted during the past years, little improvement in overall survival has been achieved for patients with advanced disease. Chemotherapy and radiation continue to be the mainstays of treatment for unresectable patients, and targeted agents seem to have added little improvement to overall survival while dramatically increasing costs and producing significant clinical side effects. In contrast to the immunosuppression which occurs as a result of the use of chemotherapy and pathway blockers, novel therapies are emerging which either stimulate tumor specific immune responses due to apoptotic focal tumor destruction or attack tumor-induced regulatory T-cell immunosuppression. Such new approaches should be fully explored, as they have potential to offer very different outcomes for advanced lung cancer patients.

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R. Lencioni, J. Chen, G. Downie and L. Keltner, "Advanced Lung Cancer—Reaching a Survival Ceiling with Chemotherapy, the Nibs, and the Mabs," Journal of Cancer Therapy, Vol. 2 No. 2, 2011, pp. 157-160. doi: 10.4236/jct.2011.22018.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] G. D’Addario, D. Rauch, R. Stupp, M. Pless, R. Stahel, N. Mach, L. Jost, L. Widmer, C. Tapia, M. Bihl, M. Mayer, K. Ribi, S. Lerch, L. Bubendorf and D. C. Betticher, “Multicenter Phase II Trial of Gefitinib First-Line Therapy Followed by Chemotherapy in Advanced Non- Small-Cell Lung Cancer (NSCLC): SAKK Protocol 19/03,” Annals of Oncology, Vol. 19, No. 4, 2008, pp. 739-745. doi:10.1093/annonc/mdm564
[2] S. Huq, I. Maghfoor and M. Perry, “Lung Cancer, Non-Small Cell,” Medscape.com, 2009. http://emedicine. medscape.com/article/279960-print.)
[3] S. Reinberg, “More Dollars Don’T Boost Lung Cancer Survival,” 2007. http://health.usnews.com/usnews/health/healtday/071023/more-dollars-dont-boost-lung-cancer-survival.htm.)
[4] D. Morgensztern, S. Waqar, J. Subramanian, F. Gao and R. Govindan, “Improving Survival for Stage IV Non-Small Cell Lung Cancer: A Surveillance, Epidemiology, and End Results Survey from 1990 to 2005,” Journal of Thoracic Oncology, Vol. 4, No. 12, 2009, pp. 1524-1529. doi:10.1097/JTO.0b013e3181ba3634
[5] K. L. Reckamp, B. K. Gardner, R. A. Figlin, D. Elashoff, K. Krysan, M. Dohadwala, J. Mao, S. Sharma, L. Inge, A. Rajasekaran and S. M. Dubinett, “Tumor Response to Combination Celecoxib and Erlotinib Therapy in Non- Small Cell Lung Cancer is Associated with a Low Baseline Matrix Metalloproteinase-9 and a Decline in Serum-Soluble E-cadherin,” Journal of Thoracic Oncology, Vol. 3, No. 2, 2008, pp. 117-124. doi:10.1097/JTO.0b013e3181622bef
[6] E. A. Kotteas, A. G. Charpidou and K. N. Syrigos, “Targeted Therapy for Nonsmall Cell Lung Cancer: Focusing on Angiogenesis, the Epidermal Growth Factor Receptor and Multikinase Inhibitors,” Anticancer Drugs, Vol. 21, No. 2, 2010, pp. 151-168. doi:10.1097/CAD.0b013e328334da02
[7] C. G. Azzoli, S. Baker Jr., S. Temin, W. Pao, T. Aliff, J. Brahmer, D. H. Johnson, J. L. Laskin, G. Masters, D. Milton, L. Nordquist, D. G. Pfister, S. Piantadosi, J. H. Schiller, R. Smith, T. J. Smith, J. R. Strawn, D. Trent and G. Giaccone, “American Society of Clinical Oncology Clinical Practice Guideline Update on Chemotherapy for Stage IV Non-Small-Cell Lung Cancer,” Journal of Clinical Oncology, Vol. 27, No. 36, 2009, pp. 6251-6266. doi:10.1200/JCO.2009.23.5622
[8] G. V. Scagliotti, P. Parikh, J. von Pawel, B. Biesma, J. Vansteenkiste, C. Manegold, P. Serwatowski, U. Gatzemeier, R. Digumarti, M. Zukin, J. S. Lee, A. Mellem- gaard, K. Park, S. Patil, J. Rolski, T. Goksel, F. de Marinis, L. Simms, K. P. Sugarman and D. Gandara, “Phase III Study Comparing Cisplatin Plus Gemcitabine with Cisplatin Plus Pemetrexed in Chemotherapy-Naive Patients with Advanced-Stage Non-Small-Cell Lung Cancer,” Journal of Clinical Oncology, Vol. 26, No. 21, 2008, pp. 3543-3551. doi:10.1200
[9] A. Sandler, “Bevacizumab in Non Small Cell Lung Cancer,” Clinical Cancer Research, Vol. 13, No. 15, 2007, pp. s4613-4616. doi:10.1158/1078-0432.CCR-07-0647
[10] T. Fojo and C. Grady, “How Much is Life Worth: Cetuximab, Non-Small Cell Lung Cancer, and the $440 Billion Question,” Journal of the National Cancer Institute, Vol. 101, No. 15, 2009, pp. 1044-1048. doi:10.1093/jnci/djp177
[11] H. A. Burris, “Shortcomings of Current Therapies for Non-Small-Cell Lung Cancer: Unmet Medical Needs,” Oncogene, Vol. 28, No. 1 (Supplement), 2009, pp. S4-13. doi:10.1038/onc.2009.196
[12] T. Fong, D. Morgensztern and R. Govindan, “EGFR Inhibitors as First-Line Therapy in Advanced Non-Small Cell Lung Cancer,” Journal of Thoracic Oncology, Vol. 3, No. 3, 2008, pp. 303-310. doi:10.1097/JTO.0b013e3181645477
[13] L. Horn and A. Sandler, “Epidermal Growth Factor Receptor Inhibitors and Antiangiogenic Agents for the Treatment of Non-Small Cell Lung Cancer,” Clinical Cancer Research, Vol. 15, No. 16, 2009, pp. 5040-5048. doi:10.1158/1078-0432.CCR-09-0520
[14] National Institute for Health and Clinical Excellence, “NICE Technology Appraisal Guidance 162, Erlotinib for the Treatment of Non-Small-Cell Lung Cancer,” 2010. http://www.nice.org.uk/TA162.
[15] T. S. Mok and S. S. Ramalingam, “Maintenance Therapy in Nonsmall-Cell Lung Cancer: A New Treatment Paradigm,” Cancer, Vol. 115, No. 22, 2009, pp. 5143-5154. doi:10.1002/cncr.24563
[16] M. S. Reif and M. P. Rivera, “Evidence-Based Outcomes for Patients with Advanced Non-Small Cell Lung Cancer,” Seminars in Respiratory and Critical Care Medicine, Vol. 21, No. 1, 2000, pp. 443-449. doi:10.1055/s-2000-9405
[17] K. Suda, K. Tomizawa and T. Mitsudomi, “Biological and Clinical Significance of KRAS Mutations in Lung Cancer: An Oncogenic Driver that Contrasts with EGFR Mutation,” Cancer and Metastasis Reviews, Vol. 29, No. 1, 2010, pp. 49-60. doi:10.1007/s10555-010-9209-4
[18] B. Boughton, “Two Clinical Trials on Gefitinib Show Benefits for Asian Lung Cancer Patients,” Medscape.com, 2009.http://www.medscape.com/viewarticle/707751_print.)
[19] S. M. Gadgeel, “Targeted Therapy in Lung Cancer: The Good, the Bad, and the Ugly,” Clinical Lung Cancer, Vol. 10, No. 1, 2009, pp. 10-12. doi:10.3816/CLC.2009.n.002
[20] E. D. Pleasance, P. J. Stephens, S. O’Meara, D. J. McBride, A. Meynert, D. Jones, M. L. Lin, D. Beare, K. W. Lau, C. Greenman, I. Varela, S. Nik-Zainal, H. R. Davies, G. R. Ordonez, L. J. Mudie, C. Latimer, S. Edkins, L. Stebbings, L. Chen, M. Jia, C. Leroy, J. Marshall, A. Menzies, A. Butler, J. W. Teague, J. Mangion, Y. A. Sun, S. F. McLaughlin, H. E. Peckham, E. F. Tsung, G. L. Costa, C. C. Lee, J. D. Minna, A. Gazdar, E. Birney, M. D. Rhodes, K. J. McKernan, M. R. Stratton, P. A. Futreal and P. J. Cam
[21] C. Gridelli, P. Maione, A. Rossi, G. Palazzolo, G. Colantuoni and E. Rossi, “Management of Unfit Older Patients with Advanced NSCLC,” Cancer Treatment Reviews, Vol. 35, No. 6, 2009, pp. 517-521. doi:10.1016/j.ctrv.2009.04.011
[22] L. A. Emens, J. P. Machiels, R. T. Reilly and E. M. Jaffee, “Chemotherapy: Friend or Foe to Cancer Vaccines?” Current Opinion in Molecular Therapeutics, Vol. 3, No. 1, 2001, pp. 77-84.
[23] M. Krusch, J. Salih, M. Schlicke, T. Baessler, K. M. Kampa, F. Mayer and H. R. Salih, “The Kinase Inhibitors Sunitinib and Sorafenib Differentially Affect NK Cell Antitumor Reactivity in Vitro,” The Journal of Immunology, Vol. 183, No. 12, 2009, pp. 8286-8294. doi:10.4049/jimmunol.0902404
[24] K. R. Molhoek, C. C. McSkimming, W. C. Olson, D. L. Brautigan and C. L. Slingluff Jr., “Apoptosis of CD4(+) CD25(high) T Cells in Response to Sirolimus Requires Activation of T Cell Receptor and is Modulated by IL-2,” Cancer Immunology Immunotherapy, Vol. 58, No. 6, 2009, pp. 867-876. doi:10.1007/s00262-008-0602-6
[25] E. Bromley, B. Owczarczak, L. Keltner, S. Wang and S. O. Gollnick, “Characterization of an Anti-Tumor Immune Response after Light-Activated Drug Therapy Using Talaporfin Sodium in a Spontaneously Metastasizing Mammary Tumor Model,” Journal of Clinical Oncology, Vol. 27, No. 15s, 2009, p. 3052.
[26] J. D. Wolchok, B. Neyns, G. Linette, S. Negrier, J. Lutzky, L. Thomas, W. Waterfield, D. Schadendorf, M. Smylie, T. Jr. Guthrie, J. J. Grob, J. Chesney, K. Chin, K. Chen, A. Hoos, S. J. O’Day and C. Lebbe, “Ipilimumab Monotherapy in Patients with Pretreated Advanced Melanoma: A Randomised, Double-Blind, Multicentre, Phase 2, Dose-Ranging Study,” The Lancet Oncology, Vol. 11, No. 2, 2010, pp. 155-164. doi:10.1016/S1470-2045(09)70334-1

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