Overview of Efficacy and Limitation of Standard and Targeted Therapy for Malignant Disease Using Lung Cancer as a Case Study



Recent advances in the understanding of the molecular basis of cancer have translated to the development of effective therapeutic modalities for certain types of malignant tumors. Significant percentages of solid tumors present with locally advanced or metastastic disease for which systemic chemotherapy, with or without radiotherapy, is the only treatment option. Cytotoxic drugs discovered by the screening of natural compounds or by medicinal chemistry are the mainstay of our current chemotherapy armamentarium for cancers. Only incremental improvements of therapeutic benefits have been achieved with the testing of different combinations and permutations of standard cytotoxic drugs given at maximal tolerable doses, leading to the notion that a therapeutic plateau has been reached for cancer chemotherapy. This provides impetus for the development of more innovative therapeutic strategies using newer drug schedules and novel agents targeting signal transduction pathways or cellular processes essential for cancer growth and metastasis. An overview of lung cancer therapy is used in this paper to illustrate the evolving paradigm of modern oncology. The future of cancer chemotherapy will most likely be a hybrid of cytotoxic drugs combined with molecularly targeted agents that are individually tailored to the patient’s specific genotype and phenotype. In this context, chemical libraries derived from natural products have the potential to identify novel agents with complex structure, chirality, and multiple pharmacophores suitable to interfere with single or multiple cancer targets.


Advanced NSCLC Malignant Pleural Effusion EGFR Mutation Mediastinal Lymph Node Metastasis Sublobar Resection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Adjuvant Navelbine International Trialist Association


Computed axial tomography


Epidermal growth factor receptor


European Organization for Research and Treatment of Cancer


Estrogen receptor


International Adjuvant Lung Cancer Trial Collaboratory Group


Magnetic resonance imaging


Non-small cell lung cancer


Positron emission tomography


Progesterone receptor


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Thoracic Surgery Section, Division of Cardiothoracic Surgery, The DeWitt Daughtry Family Department of Surgery Leonard M. Miller Faculty of MedicineUniversity of MiamiMiamiUSA

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