Published online May 10, 2014. doi: 10.5306/wjco.v5.i2.103
Revised: December 24, 2013
Accepted: March 17, 2014
Published online: May 10, 2014
The purpose of this article is to review the role of maintenance therapy in the treatment of advanced non-small cell lung cancer (NSCLC). A brief overview about induction chemotherapy and its primary function in NSCLC is provided to address the basis of maintenance therapies foundation. The development of how maintenance therapy is utilized in this population is discussed and current guidelines for maintenance therapy are reviewed. Benefits and potential pitfalls of maintenance therapy are addressed, allowing a comprehensive review of the achieved clinical benefit that maintenance therapy may or may not have on NSCLC patient population. A review of current literature was conducted and a table is provided comparing the results of various maintenance therapy clinical trials. The table includes geographical location of each study, the number of patients enrolled, progression free survival and overall survival statistics, post-treatment regimens and if molecular testing was conducted. The role of molecular testing in relation to therapeutic treatment options for advanced NSCLC patients is discussed. A treatment algorithm clearly depicts first line and second line treatment for management of NSCLC and includes molecular testing, maintenance therapy and the role clinical trials have in treatment of NSCLC. This treatment algorithm has been specifically tailored and developed to assist clinicians in the management of advanced NSCLC.
Core tip: This review article addresses the role of maintenance therapy in the treatment of advanced non-small cell lung cancer (NSCLC). Maintenance therapy utilization in NSCLC patient population and review of current guidelines for maintenance therapy are discussed. A treatment algorithm was created to depict first line and second line treatment for managing NSCLC and includes molecular testing, maintenance therapy, and the role of clinical trials in the treatment of NSCLC. A comprehensive review of the achieved clinical benefit that maintenance therapy may or may not have on the NSCLC patient population is presented.