From the Division of Hematology/Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PA
Authors’ disclosures of potential conflicts of interest are found at the end of this article.
Address reprint requests to Tracey L. Evans, MD, University of Pennsylvania, 12 Penn Tower, 3400 Spruce St, Philadelphia, PA 19104; e-mail: tracey.evans{at}uphs.upenn.edu
Overview: Recent progress in the treatment of metastatic non-small cell lung cancer using novel, targeted agents has not yet translated into new treatments for locally advanced disease. Clinical trials incorporating these agents into multimodality therapy involving definitive thoracic radiation are ongoing. Thus far, the use of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) has been disappointing. Although the use of monoclonal antibodies such as cetuximab and bevacizumab may yield better results, combining such agents with radiation does introduce new mechanisms for potential toxicity. Appropriate patient selection, likely based on predictive molecular tumor markers, and determining with which other therapies these agents are potentially synergistic or antagonistic, are critical in establishing the optimal use of these agents in the locally advanced patient population.
