Prefacio

Las tasas de mortalidad del cáncer de pulmón han descendido en los varones y las mujeres en estos últimos años. La detección precoz, el mejor conocimiento de la biología tumoral y toda una serie de nuevas opciones de tratamiento han hecho posible este avance. No obstante, el cáncer de pulmón sigue siendo la principal causa de muerte por cáncer en Estados Unidos y en el resto del mundo, lo que ha incitado a la comunidad científica a perseverar en sus esfuerzos de investigación y a trasladarlos a ámbitos caracterizados tradicionalmente por escasos progresos, como el cáncer de pulmón microcítico (CPM).

PFS improvement due to local therapy in oligometastatic NSCLC

Evidence suggests the existence of a ,limited metastatic’ NSCLC phenotype. However, the type of optimal treatment and the role of aggressive local therapy in these patients remain controversial. Gomez et al. presented the first prospective, randomised trial to address this question. Patients had stage IV disease without RECIST progression and a maximum of three metastases after front-line systemic therapy (FLST).

ULTIMATE: chemotherapy plus bevacizumab beyond first line

As chemotherapy in the second-line or third-line settings of NSCLC shows limited efficacy, the phase III, randomised ULTIMATE trial tested the combination of chemotherapy and bevacizumab in patients with advanced NSCLC of non-squamous histology, who had progressed after one or two lines of treatment.

New approaches are raising hope for SCLC patients

Only minor progress has been made over the past 30 to 40 years in the treatment of small-cell lung cancer (SCLC), which accounts for 10 % to 15 % of lung cancer cases. SCLC is radiosensitive, but approximately 70 % of patients present with extended disease that cannot be included within one radiotherapy field. The majority of patients respond to first-line chemotherapy.

Mutational analysis: on the road to refined standards

The Lung Cancer Mutation Consortium (LCMC) is a multi-institutional consortium for the study of driver mutations of lung adenocarcinoma. The cooperating sites enable the identification of relatively large numbers of patients with uncommon and rare alterations, facilitate the analysis of their clinical characteristics, and lay the ground for targeted therapy trials.

Exploring established and novel EGFR-directed agents

The phase IIb LUX-Lung 7 trial was a head-to-head comparison of the second- generation ErbB family blocker afatinib and the first-generation reversible EGFR TKI gefitinib in patients with treatment-naïve, EGFR-mutation-positive, advanced (stage IIIB/IV) adenocarcinoma of the lung.According to the primary analysis, patients treated with afatinib derived significant PFS, ORR and time-to-treatment-failure benefits compared to those who received gefitinib.

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