1.

• M.V. Lomonosov Moscow State University Faculty of Basic Medicine

• Supervisor:

• M.D. A.F.Marenich

• 2010,Moscow

2.

• Lung cancer is the commonest malignancy and leading cause of cancer deaths.

• At the moment , the development of Non Small Cell Lung Cancer (NSCLC) in 25 30% of cases is diagnosed the local-extended process and in 40 50% distant metastasis are revealed.

• The conservative methods of treatment occupy key place.

3.

• The 5-year relative survival rate varies markedly depending on the stage at diagnosis, from 49% to 16% to 2% for patients with local, regional, and distant stage disease respectively.

• According to stages

• I - > 60%

• II - 30 - 60%

• III - 5 - 30%

• IV - < 5%

• If high mitotic rate and tumor necrosis associated with poor prognosis.

4. Published Chemotherapy Regimens Schedule 1 Cisplaitn 50 mg/m 2 days 1 and 8 Vinorelbine 25 mg/m 2 days 1, 8, 15, 22 Every 28 days for 4 cycles 2 Cisplaitn 100 mg/m 2 on day 1 Vinorelbine 30 mg/m 2 days 1, 8, 15, 22 Every 28 days for 4 cycles 3 Cisplaitn 75-80 mg/m 2 on day 1 Vinorelbine 25-30 mg/m 2 days 1, 8 Every 28 days for 4 cycles 4 Cisplaitn 100 mg/m 2 on day 1 Etoposide 100 mg/m 2 day 1-3 Every 28 days for 4 cycles 5 Cisplaitn 80 mg/m 2 day 1 Vinblastine 4 mg/m 2 days 1, 8, 15, 22 Every 28 days for 4 cycles Acceptable Cisplaitn-base Regimens 1 Cisplatin 80 mg/m 2 on day 1 Gemcitabine 1000 mg/m 2 on days 1, 8 Every 21 days 2 Cisplatin 80 mg/m 2 Docetaxel 75 mg/m 2 Every 21 days Chemotherapy Regimens for patients with comorbidities or patients not able to tolerate cisplatin 1 Paclitaxel 200 mg/m 2 on day 1 Carboplatin AUC 6 on day 1 Every 21 days

5.

• EGFR is expressed in 40 - 80% of lung cancers.

• Gefitinib (Iressa 250 mg) and erlotinib (Tarseva 150 mg) were the first two agents to target the tyrosine kinase of the EGFR. Both of these agents have activity in NSCLC.

• On the 1 st July 2009 the European Commission granted marketing authorisation for IRESSA for the treatment of adults with locally advanced or metastatic NSCLC.

• The National Institute for Clinical Excellence (NICE) has approved Tarceva as an alternative treatment to the chemotherapy drug docetaxel for people with non-small cell lung cancer.

• Bevacizumab, to improve survival when combined with chemotherapy in the first-line setting.

• In currently aflibercept with the combination of other drugs is in phase III cliinical trails.

6.

• To determine the significant effects of different chemotherpy regimes

7.

• To identify which one is more effective than other chemotherapy regimes

• To determine the toxicities of the drugs

8.

• Patients and method

• Retrospective study

• Patients

• - 95 patients with nom small cell lung cancer stage III IV (Blokhins Russian Cancer Research Center from 2007 to march 2008) ECOG performance status