The Role of Systemic Anti-Cancer Therapy in the Management of Lung Carcinoma

The aim of this chapter is to describe the role of systemic anti-cancer therapy in the management of lung cancer. The introduction describes the different sub-types of lung cancer as this is highly pertinent to the treatment options available. We move on to discuss the main sub-types of systemic anti-cancer therapy used for lung cancer and their mechanisms of action; specifically regarding cytotoxic chemotherapy, targeted therapy including tyrosine kinase inhibitors, monoclonal antibodies and immunotherapy, namely checkpoint inhibitors. From here we move on to discuss adjuvant systemic anti-cancer therapy following surgical resection for both small cell lung cancer and non-small cell lung cancer. Following this, we move on to describe systemic anti-cancer therapy for incurable lung cancer starting with the recent historical perspective and the remarkable changes and developments that have occurred in this field over the last ten years. We discuss systemic therapy for small cell lung cancer and non-small cell lung cancer, focussing on non-mutated adenocarcinoma, EGFR and ALK mutant adenocarcinoma and squamous cell lung cancer. In conclusion, we describe future perspectives and the importance of a joined-up approach to diagnosis, investigation and management to improve outcomes for patients with lung cancer.

Keywords: ALK Mutant Lung Cancer, Adjuvant Systemic Anti-Cancer Therapy, Cytotoxic Chemotherapy, Checkpoint Inhibitors, EGFR Mutant Lung Cancer, Immunotherapy, Monoclonal Antibodies, Non-Small Cell Lung Carcinoma, Palliative Systemic Anti-Cancer Therapy, Ros-1 Mutant Lung Cancer, Systemic Anti-Cancer Therapy, Small-Cell Lung Cancer, Tyrosine Kinase Inhibitors.