Future Scenarios for the Treatment of Advanced Non-Small Cell Lung Cancer: Focus on Taxane-Containing Regimens

Abstract

Despite recent progress in the development of new molecularly targeted agents, the chemotherapy regimens considered standard at the end of the last century-that is, two-drug combinations consisting of either cisplatin or carboplatin plus a third-generation agent (docetaxel, paclitaxel, gemcitabine, or vinorelbine)-remain the primary treatment option for advanced non-small cell lung cancer (NSCLC) patients. Most recently, the existing standard of care has been amended to reflect the significant survival advantage of cisplatin-pemetrexed over cisplatin-gemcitabine as first-line treatment of nonsquamous NSCLC. The addition of a biological drug (bevacizumab, cetuximab) or the use of a singleagent epidermal growth factor receptor inhibitor may further improve outcomes in selected patients.It has become increasingly clear, primarily through recent meta-analyses, that although the therapeutic equivalence of any combination of a platinum agent plus either gemcitabine, vinorelbine, docetaxel, or paclitaxel has been long accepted, each regimen has different side effects and therapeutic outcomes that allow clinicians to select the most appropriate treatment for chemotherapy-naïve patients with stage IIIB/IV NSCLC. In this review, we evaluate the available evidence and explore the role and importance of various modern chemotherapy regimens, with the aim of optimizing treatment selection and combination with biological agents. Emphasis is placed on the role of taxanes (docetaxel versus paclitaxel) in this changing landscape.

A Model of Toxic Neuropathy inDrosophilaReveals a Role for MORN4 in Promoting Axonal Degeneration

“…Taxol causes sensory neuropathy which manifests as pain and loss of sensation in extremities, while vincristine causes both sensory and motor dysfunction. These drugs are used widely in both pediatric and adult patients to treat aggressive metastatic cancer (Sparano, 2000; Bradley and Hussain, 2008; Marsh, 2009; Moore and Pinkerton, 2009; Grossi et al, 2010). Because we know so little about the mechanisms causing this severe side effect, we currently have no way to prevent axonal degeneration in these patients.…”

Targeting KRAS-Mutant Non–Small Cell Lung Cancer with the Hsp90 Inhibitor Ganetespib

“…Platinum-based combination chemotherapy represents the standard-of-care for individuals with advanced NSCLCs (2), although this approach has largely reached a plateau of effectiveness in improving overall survival (3,4). Intensive research into the underlying biologic and molecular basis of NSCLCs has provided critical insights into essential oncogenic pathways that become dysregulated during tumorigenesis and, in turn, has identified important targets for drug development.…”

Fucoidan, A Sulfated Polysaccharides from Brown Algae as Therapeutic Target for Cancer

“…Several different therapeutic strategies such as chemotherapy, radiation therapy, surgery or combinations have been used to treat different types of cancer. Unfortunately, several of these treatments provide only minimal benefits; moreover, complications and long term side effects of these treatments [76,77]. Chemotherapy is one of the mostly used therapeutic modalities for the treatment of cancer, but it does not achieve a satisfactory therapeutic result.…”