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Future Oncol. 2019 Feb 13. doi: 10.2217/fon-2018-0948. [Epub ahead of print]

Defining aggressive or early progressing nononcogene-addicted non-small-cell lung cancer: a separate disease entity?

Author information

1
Department of Thoracic Oncology, Lung Clinic Grosshansdorf, Member of the German Center for Lung Research (DZL), Grosshansdorf, Germany.
2
Department of Pathology, Aberdeen University Medical School, Aberdeen Royal Infirmary, Aberdeen, Scotland.
3
Department of Respiratory Diseases, Evangelische Lungenklinik Berlin, Lindenberger Weg 27, Berlin, Germany.
4
Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.
5
Department of Medical Oncology, Royal North Shore Hospital (Sydney University), Reserve Road, St Leonards 2065, New South Wales, Australia.
6
Medical Oncology Department, University Hospital 12 de Octubre, Complutense University, CNIO & CiberOnc, Madrid, Spain.
7
Division of Respiratory Medicine & Thoracic Oncology, Ludwig Maximilians University of Munich, & Thoracic Oncology Centre Munich, Member of the German Center for Lung Research (DZL CPC-M) Munich, Germany.
8
Department of Medicine, Royal Marsden Hospital NHS Foundation Trust, London, UK.
9
Department of Medical Oncology, Christie Hospital NHS Trust, Wilmslow Road, Manchester, UK.
10
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
11
Boehringer Ingelheim RCV GmbH & Co. KG, A-1121, Vienna, Austria.
12
Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, Connecticut, CT 06877, USA.
13
Boehringer Ingelheim Pharma GmbH & Co, KG, Germany & Institute of Pharmacology, Johannes Gutenberg-University Mainz, Germany.

Abstract

A substantial proportion of patients with nononcogene-addicted non-small-cell lung cancer (NSCLC) has 'aggressive disease', as reflected in short time to progression or lack of disease control with initial platinum-based chemotherapy. Recently, clinical correlates of aggressive disease behavior during first-line therapy have been shown to predict greater benefit from addition of nintedanib to second-line docetaxel in adenocarcinoma NSCLC. Positive predictive effects of aggressive disease have since been reported with other anti-angiogenic agents (ramucirumab and bevacizumab), while such features may negatively impact on outcomes with nivolumab in nonsquamous NSCLC with low programmed death-ligand 1 expression. Based on a review of the clinical data, we recommend aggressive nonsquamous NSCLC should be defined by progression within <6-9 months of first-line treatment initiation.

KEYWORDS:

aggressive; anti-angiogenic therapy; non-small-cell lung cancer

PMID:
30758227
DOI:
10.2217/fon-2018-0948
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