Chemotherapy: Open Access
Open Access

Abstract

Neoadjuvant use of Tyrosine Kinase Inhibitors

Mariano Provencio Pulla, Antonio Sánchez Ruiz, Magda Palka Kotlowsk and Miriam Méndez Garcia

Patients with clinical stage IIIA-N2 non-small cell lung cancer (NSCLC) have a 5-year

overall survival

(OS) of only 10%-15%, and it decreases to 2-5% in patients with mediastina N2 bulky disease. The efficacy of

surgery

in this stage is limited and remains controversial. In 4 different studies with a total of 1180 patients who underwent surgical resection, 5-year survival was 14-30% [1-4]. To improve this rate and supported by the introduction of new chemotherapeutic agents, induction chemotherapy (CT) has been added to the treatment approach in this stage. The theoretical advantages of induction CT include: in vivo assessment of response to CT, which would help identify patients who might benefit from

adjuvant

CT; early treatment of micro metastasis to increase control of distant metastases; reduction of drug resistance due to early exposure to

chemotherapeutic agents

and increased surgical resect ability, due to enhance of response rates that also allows preservation of healthy lung parenchyma.