Non small cell lung cancer medical therapy stage IV: Difference between revisions
(Mahshid) |
|||
(2 intermediate revisions by the same user not shown) | |||
Line 6: | Line 6: | ||
==Overview== | ==Overview== | ||
Therapies for non-small cell lung cancer stage IV | Therapies for non-small cell lung cancer stage IV include [[cytotoxic]] combination [[chemotherapy]] (first line), combination chemotherapy with bevacizumab or cetuximab, EGFR [[tyrosine kinase inhibitors]], EML4-ALK inhibitors in patients with EML-ALK translocations, and immune checkpoint inhibition with nivolumab for selected patients with squamous or non-squamous metastatic. Maintenance therapy following first-line chemotherapy, include endobronchial laser therapy or [[brachytherapy]] (for obstructing lesions) and external-beam radiation therapy (primarily for palliation of local symptomatic tumor growth). Local therapies (ambulatory catheter drainage, [[pleurodesis]] or mediastinal window) plus therapy for [[Non small cell lung cancer medical therapy metastatic cancer#Medical Therapy for Metastatic Non-Small Cell Lung Cancer|systemic metastasis]] is the preferred combination for patients with stage IV M1a non-small cell lung cancer. Patients with solitary site [[metastasis]] (stage IV M1b) should be treated according to the site of [[metastasis]]. | ||
==Medical Therapy for Stage IV Non-Small Cell Lung Cancer== | ==Medical Therapy for Stage IV Non-Small Cell Lung Cancer== |
Latest revision as of 23:31, 23 February 2018
Non Small Cell Lung Cancer Microchapters |
Differentiating Non Small Cell Lung Cancer from other Diseases |
---|
Diagnosis |
Treatment |
Case Studies |
Non small cell lung cancer medical therapy stage IV On the Web |
American Roentgen Ray Society Images of Non small cell lung cancer medical therapy stage IV |
Non small cell lung cancer medical therapy stage IV in the news |
Blogs on Non small cell lung cancer medical therapy stage IV |
Directions to Hospitals Treating Non small cell carcinoma of the lung |
Risk calculators and risk factors for Non small cell lung cancer medical therapy stage IV |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alonso Alvarado, M.D. [2] Maria Fernanda Villarreal, M.D. [3]
Overview
Therapies for non-small cell lung cancer stage IV include cytotoxic combination chemotherapy (first line), combination chemotherapy with bevacizumab or cetuximab, EGFR tyrosine kinase inhibitors, EML4-ALK inhibitors in patients with EML-ALK translocations, and immune checkpoint inhibition with nivolumab for selected patients with squamous or non-squamous metastatic. Maintenance therapy following first-line chemotherapy, include endobronchial laser therapy or brachytherapy (for obstructing lesions) and external-beam radiation therapy (primarily for palliation of local symptomatic tumor growth). Local therapies (ambulatory catheter drainage, pleurodesis or mediastinal window) plus therapy for systemic metastasis is the preferred combination for patients with stage IV M1a non-small cell lung cancer. Patients with solitary site metastasis (stage IV M1b) should be treated according to the site of metastasis.
Medical Therapy for Stage IV Non-Small Cell Lung Cancer
The algorithms for the treatment of stage IV non small cell carcinoma of the lung are based on the 2014 NCCN Non-Small Cell Lung Cancer guidelines.[1]
Is pleural or pericardial effusion present (suggestive of M1a) or are findings suggestive of systemic metastasis (M1b) present? | |||||||||||||||||||||||||||||||||||||||||||||
M1a | M1b: solitary site systemic metastasis | ||||||||||||||||||||||||||||||||||||||||||||
Perform the following tests:
| Perform the following tests:
| ||||||||||||||||||||||||||||||||||||||||||||
Is the liquid extracted positive for malignant cells? | Are findings suggestive of adrenal metastasis or brain metastasis? | ||||||||||||||||||||||||||||||||||||||||||||
Yes | No | Adrenal | Brain | ||||||||||||||||||||||||||||||||||||||||||
Local therapy
PLUS | Perform a needle aspiration biopsy for metastasis confirmation | Surgical resection + adjuvant radiation therapy Radiation therapy alone:
PLUS | |||||||||||||||||||||||||||||||||||||||||||
If the lung disease is curable, administer local therapy for the adrenal lesion:
OR | What is the TN stage of the lung tumor? | ||||||||||||||||||||||||||||||||||||||||||||
|
| ||||||||||||||||||||||||||||||||||||||||||||
| Administer therapy for metastatic disease in case of not curable lung lesions (click here for the treatment of metastatic cancer) | ||||||||||||||||||||||||||||||||||||||||||||