Novel Cytotoxic Agents in Combination with Radiation in the Management of Locally Advanced Non-Small Cell Lung Cancer: Focus on Pemetrexed and Nab-Paclitaxel [Abraxane]

  • Corey J. Langer
Part of the Medical Radiology book series (MEDRAD)


The treatment of locally advanced, unresectable non-small cell lung cancer (NSCLC) remains challenging. Radiation therapy (RT) combined with chemotherapy is more effective than RT alone, and concomitant chemoradiation has yielded improved survival compared to sequential chemotherapy and RT, but at the cost of heightened toxicity, especially esophagitis. The majority of randomized chemoradiation trials have featured cisplatin or carboplatin based chemotherapy, usually in combination with either etoposide or paclitaxel, with median survival times of 16–18 months, and 5 year survival rates of 15 to 20% at best. In this chapter, we describe recent studies employing pemetrexed and nab-paclitaxel, each of which has been extensively investigated in advanced disease, the former yielding improved progression-free and overall survival in adenocarcinoma both in the frontline and maintenance setting, the latter yielding superior response rates in squamous cell carcinoma compared to conventional paclitaxel in chemo-naïve patients. Both agents have demonstrated safety and efficacy in LA-NSCLC in conjunction with RT. Whether these agents will ever prove superior to either etoposide or paclitaxel in this setting will require careful, phase III testing.


Advanced NSCLC Overall Response Rate Thoracic Radiation Anal Canal Cancer Nonsquamous NSCLC 
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© Springer-Verlag Berlin Heidelberg  2011

Authors and Affiliations

  1. 1.Abramson Cancer CenterUniversity of PennsylvaniaPhiladelphiaUSA

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