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 PD-L1 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.
- Reck, M.
- Kerr, K. M.
- Grohe, C.
- Manegold, C.
- Pavlakis, N.
- Paz-Ares, L.
- Huber, R. M.
- Popat, S.
- Thatcher, N.
- Park, K.
- Hilberg, F.
- Barrueco, J.
- Kaiser, R.
Keywords
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Humanized
- Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
- Bevacizumab/therapeutic use
- Carcinoma, Non-Small-Cell Lung/*drug therapy/mortality/pathology
- Disease Progression
- Disease-Free Survival
- Docetaxel/therapeutic use
- Humans
- Indoles/therapeutic use
- Lung/*pathology
- Lung Neoplasms/*drug therapy/mortality/pathology
- *Patient Selection
- Time Factors
- aggressive
- anti-angiogenic therapy
- non-small-cell lung cancer
