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Chief of Hematology/Oncology and Medical Director at Memorial Cancer Institute, and Clinical Associate Professor of Medicine at Florida International University

Chief of Hematology/Oncology
Medical Director of Memorial Cancer Institute

Lung Cancer Video Library - Spanish Language: Video #25 Second-line Therapies for Advanced NSCLC
Thu, 02/02/2017 - 10:58
Luis Raez, MD FACP FCCP, Faculty, Board Member

Terapias de segunda línea para el cancer de pulmón de células no pequeñas en estadio avanzado

El tratamiento estándar para segunda línea, consta de 3 fármacos aprobados que son pemetrexed, docetaxel y erlotinib, estas fueron aprobadas para pacientes que fallaron en primera línea de quimioterapia.

Hoy en día tenemos la inmunoterapia como nivolumab y pembrolizumab que son inhibidores de los puntos de control, que actualmente ya están aprobados para cancer de pulmón. Es por eso que ahora tenemos 5 opciones de segunda línea para el paciente con cancer de pulmón. Estos se usan basado en el paciente, su estadio físico y posibles complicaciones, así uno decide cual es mejor que otro.

Obviamente, la mayoría de médicos y pacientes prefieren que se use inmunoterapia porque es menos toxica y porque los estudios por los cuales la inmunoterapia se aprobó, mostraron que la inmunoterapia era superior a la quimioterapia de segunda línea.

 Por esa razón, no es porque yo este sesgado, a pesar de que hay 5 agentes aprobados en segunda línea, probablemente la mejor opción de segunda línea es inmunoterapia con los 2 agentes aprobados nivolumab y pembrolizumab y otros agentes inmunoterapeúticos que van a ser aprobados pronto.

Second line therapies for non-small cell lung cancer in advanced stage

The standard treatment in second line therapies, consists of three approved drugs that are pemetrexed, docetaxel and erlotinib. These were approved for patients that failed with the first line chemotherapy.

Nowadays, we have immunotherapy like nivolumab and pembrolizumab, that are checkpoint inhibitors that are approved for lung cancer. That is why we have five second line therapy options. These are used based on the patient, their physical state and the possible complications, so we can decide which one is better.

Obviously, most of physicians prefer immunotherapy because it’s less toxic and because in recent clinical trials, immunotherapy proved to be better over second line chemotherapy.

For this reason, not because I have personal preferences, despite the five second line approved agents, the best option is nivolumab and pembrolizumab and other agents that will we approved soon.

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