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Denise Brock

Denise has over 30 years of varying experience in the healthcare arena.  In August 2009 she joined The Global Resource for Advancing Cancer Education as one of its first employees.  She has grown with the organization and now oversees the operational movement of programs, efficiency, and effectiveness within the organization, as well as the daily processes and functions.  


Lung Cancer Video Library - Spanish Language: Video #2 What is the value of chemotherapy in advanced/metastatic NSCLC?
Denise Brock


For our second video in the GRACE Spanish Lung Cancer Library, Antonio Calles, MD, Medical Oncologist, Thoracic Oncology Program, Hospital General Universitario, Gregorio Marraron, Madrid, Spain joined GRACE to discuss what is the value of chemotherapy in advanced/metastatic NSCLC.



TRANSCRIPTS - Spanish and English

¿Cuál es el valor de la quimioterapia en el cáncer de pulmón de células no pequeñas en estadio avanzado o de metástasis?

La quimioterapia sigue siendo el tratamiento de elección en la mayor parte de los pacientes con cáncer de pulmón. El cancer de pulmón en primera línea, el estándar de tratamiento incluye una combinación de quimioterapia basada en platino, es lo que se llaman dobletes de platino: cisplatino o carboplatino con un fármaco de tercera generación.

¿Qué es lo que esperamos obtener de beneficio con la quimioterapia?

Queremos que los pacientes tengan menos síntomas derivados de la enfermedad. Al ser capaces de controlar la enfermedad, los pacientes tienen menos síntomas. Esto mejora la calidad de vida y en último término somos capaces de prolongar la vida de los pacientes. Los pacientes con cancer de pulmón que reciben quimioterapia viven más y viven mejor.

Aunque cada vez afortunadamente hay otras terapias dirigidas que han demostrado en primera línea un beneficio sobre la quimioterapia y, los recientes datos con la inmunoterapia con resultados hasta ahora nunca antes vistos de eficacia, la quimioterapia siempre es útil en alguno momento para los pacientes con cancer de pulmón.

Las células tumorales se replican, crecen más rápido que el resto de las células del organismo y ese crecimiento incontrolado puede ser frenado con fármacos citotóxicos. El cisplatino es el agente fundamental de la primera línea, la alternativa es el carboplatino. Las combinaciones de estos agentes de platino con pemetrexed, gemcitabina, vinorelbina, paclitaxel, docetaxel o abraxane (combinación de paclitaxel unida a albumina) obtiene resultados similares en primera línea de cancer de pulmón. En segundas y terceras líneas, se prefieren las monoterapias a las combinaciones para minimizar los efectos secundarios derivados de la quimioterapia.

En general, hemos avanzado no solamente en mejorar los agentes tóxicos sino también en el manejo y control de los síntomas y los efectos secundarios como las náuseas, vómitos y bajada de defensas de glóbulos rojos. Tenemos tratamientos de soporte que mejoran la tolerabilidad de la quimioterapia y al día de hoy es relativamente fácil controlar los efectos secundarios de los nuevos fármacos quimioterápicos.

What is the value of chemotherapy in non-small cell lung cancer in advanced or metastatic stage?

Chemotherapy is still the first choice treatment in most lung cancer patients. The standard first line therapy is a combination of platinum based chemotherapy, platinum doublets that include cisplatin or carboplatin and a third generation drug.

What are the benefits we are expecting from chemotherapy? We want patients to have less symptoms by controlling the disease which improves the quality of life. Overall, patients with lung cancer who receive chemotherapy, live longer and better.

Even though, now we have more targeted therapies with great benefits over chemotherapy and even immunotherapy has shown great effectiveness, chemotherapy is always useful in some point in the patient’s treatment.

Tumoral cells replicate and grow faster than the rest of the cells, and that characteristic can be stopped with cytotoxic drugs. Cisplatin is the first line agent and the alternative is carboplatin. The combination of these platinum agents with pemetrexed, gemcitabine, vinorelbine, paclitaxel, docetaxel or abraxane (combination of paclitaxel bind to albumin) gets results similar to the first line in lung cancer. In second and third line therapies, monotherapy is the best choice to minimize side effects from chemotherapy.

In general, we have progressed not only in improving toxic gents, but we have also improved the control and management of the symptoms and side effects like nausea, vomit, and low red blood cells. We now have treatments that improve tolerability to chemotherapy and it is also relatively easy to control side effects from new drugs.

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