Background:
Although well established for the effective management of hematologic
cancers, maintenance chemotherapy has only been recently incorportated as a treatment paradigm
for advanced non–small-cell lung cancer. Maintenance chemotherapy aims to prolong a clinically
favorable response state achieved after finishing induction therapy which is usually predefined in
number before startng treatment. There are 2 modalities for maintenance therapy; continuation
maintenance (involving a non-platinum component which was a part of the induction protocol or a
targeted agent) and switch maintenance therapy (utilizing a new agent which was not a part of the
induction regimen).
Methods:
The purpose of this article is to review the role of maintenance therapy in the treatment
of advanced Non-Small Cell Lung Cancer (NSCLC) and provide a brief overview about induction
chemotherapy in NSCLC to address the basis of maintenance therapy as a treatment option. We
will also compare the impact of maintenance chemotherapy with the now evolving role of
immunotherapy in NSCLC.
Results:
There have been 4 maintenance studies to date showing prolonged PFS and OS with statistical
significance. However, Three out of the four studies (ECOG4599, JMEN, and PARAMOUNT)
did not report tumor molecular analysis. As regard Immunotherapy, current data is in
favour of strongly an increasing role for immunotherapy in NSCLC.
Conclusion:
Maintenance therapy in NSCLC continues to be an important therapeutic line to improve
outcome in patients with metastatic and recurrent disease.
Gene-guided Gefitinib switch maintenance therapy for patients with advanced EGFR mutation-positive Non-small cell lung cancer: an economic analysis
