Chemotherapy for advanced non-small cell lung cancer patients with performance status 2

Curr Opin Oncol. 2005 Mar;17(2):135-9. doi: 10.1097/01.cco.0000152629.20996.9e.

Abstract

Purpose of review: A beneficial role for palliative chemotherapy in patients with advanced non-small cell lung cancer and a good performance status (ECOG 0 or 1) is now well established. In this article, we focus on the available literature for patients with a PS of 2, in whom a role for chemotherapy has yet to be defined.

Recent findings: In the past, the results of randomized trials of comparative standard platinum-based combination chemotherapy regimens have demonstrated inferior survival rates in PS 2 patients compared with those with PS 0 or 1. Consequently, a general view has emerged that the side effects of treatment outweigh the benefits, and chemotherapy has not been recommended as a standard of care. Although few studies have been designed specifically for PS 2 patients, gemcitabine, vinorelbine or taxane monotherapy, dose-attenuated platinum combination regimens, and epidermal growth factor receptor inhibitors may provide a clinical benefit with less toxicity. For example, although the median survival of PS 2 patients treated with best supportive care is 2-3 months, chemotherapy regimens are associated with median survivals ranging from 4 to 6 months. These data provide encouragement to revisit the role of chemotherapy in this group of patients.

Summary: There is potential with cytotoxic treatment to improve the palliative options for PS 2 patients with advanced non-small cell lung cancer. Further trials designed specifically for PS 2 patients that include measurement of symptoms, quality of life, and survival and toxicity are required to define the most active but least toxic regimens.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / therapeutic use*
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Carcinoma, Non-Small-Cell Lung / metabolism
  • Chemotherapy, Adjuvant
  • Epidermal Growth Factor / antagonists & inhibitors
  • ErbB Receptors / antagonists & inhibitors
  • ErbB Receptors / metabolism
  • Humans
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / metabolism
  • Protein Kinase Inhibitors / therapeutic use

Substances

  • Antineoplastic Agents
  • Protein Kinase Inhibitors
  • Epidermal Growth Factor
  • ErbB Receptors