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For patients with non-small cell lung cancer (NSCLC), whether treatment is for curative intent or palliative intent depends on an individual’s comorbidities, performance status, and tumor stage. Primo N. Lara, Jr, MD, comments that tumor stage is the primary determinant of the role of chemotherapy.
Individuals with early-stage and middle-stage disease receive platinum-based chemotherapy with curative intent. Lara notes that concurrent chemotherapy and radiation is the standard of care for patients with unresectable disease.
The goals of treatment for patients with advanced-stage disease are prolonging life, improving symptoms, and improving quality of life. Regimens for patients with advanced-stage lung cancer consist of different combinations of carboplatin, paclitaxel, bevacizumab, and pemetrexed. Jyoti D. Patel, MD, remarks that for patients with advanced disease and good performance status, platinum doublets are recommended. Bevacizumab is generally added, provided that the patient has no contraindications.
Consideration of a regimen’s adverse event profile often guides treatment selection. For instance, pemetrexed-based regimens are well tolerated, notes Benjamin P. Levy, MD, as patients do not usually experience neurotoxicity and alopecia, common side effects of taxane-based regimens.