Maintenance therapy for patients with advanced non-small cell lung cancer: Who to treat and how to treat?
Most patients with non-small cell lung cancer (NSCLC) present with advanced, metastatic disease. Although treatment of these patients was recently improved with the discovery of EGFR and ALK targeting, molecular targeted drugs, most patients require chemotherapy. The outcome of patients with advanced NSCLC lacking EGFR or ALK mutations remains disappointing, with a median overall survival of 12–14 months. To improve survival and quality of life, the concept of maintenance therapy after first-line chemotherapy has gained interest, especially in the light of efficacious and better tolerable drugs and the results of recent clinical trials. However, the topic of maintenance therapy remains controversial and complex. Therefore, we give an overview on the current evidence and discuss our personal recommendations for clinical practice.