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Although much progress has been made in terms of personalizing therapy for non-small cell lung cancer (NSCLC) and treating appropriate patients with targeted therapy, cytotoxic chemotherapy remains a backbone of treatment for most patients with advanced NSCLC, remarks Primo N. Lara, Jr, MD.
Chemotherapy has been shown to extend life and to improve quality of life in patients with advanced NSCLC, add Benjamin P. Levy, MD, and Jyoti D. Patel, MD. Advances have been made in terms of providing supportive care to patients receiving chemotherapy and improving the tolerability of treatment, comments Patel.
For patients who have driver mutations and receive targeted therapy, chemotherapy remains an option if disease progresses on targeted therapy, notes Levy. There is also some indication that chemotherapy may augment response when used with newer drugs such as PD-1 and PD-L1 immunotherapies.
Patel remarks that much work remains to be done in terms of optimizing chemotherapy for patients without targetable mutations and also in terms of salvage therapy for patients who may have a targetable mutation. Also, additional research is needed to guide the selection of therapy based on disease biology or histology; for example, to identify which cancers may be better treated by a taxane versus other types of chemotherapy. The goal is to identify the best combination based on a patient’s particular expression profile.