Novel chemotherapy regimens for advanced lung cancer: have we reached a plateau?
Lung cancer remains the most significant contributor of cancer-related mortality globally. Despite the significant progress over the last decade with the introduction of targeted and immunotherapeutic agents in the treatment of advanced non-small cell lung cancer (NSCLC), chemotherapy is still the appropriate treatment for the majority of patients. Based on clinical evidence, platinum-containing regimens have been established as the cornerstone of treatment as of today. Research efforts to optimize chemotherapy outcomes have led to novel chemotherapy regimens such as the combination of platinum plus pemetrexed as well as the addition of bevacizumab in patients with advanced non squamous NSCLC, and the combination of carboplatin with nanoparticle-albumin bound paclitaxel regardless of histology. In this article, we review clinical data regarding the recent evolution of chemotherapy in the advanced NSCLC setting, and critically evaluate the progress in therapeutic efficacy in terms of survival. We conclusively state that chemotherapy alone has reached a therapeutic plateau and report the current trends in clinical research combining chemotherapy with novel systemic therapies.