Investigational Agents in the Management of Non-Small Cell Lung Cancer

Novel therapeutic agents are playing an increasingly prominent role in the treatment of non-small cell lung cancer (NSCLC). Drugs that target important oncogenic proteins or pathways, whether used as monotherapy or in combination with established regimens, have largely supplanted traditional cytotoxic agents in modern clinical trials. In particular, inhibitors of the epidermal growth factor receptor (EGFR) and/or vascular endothelial growth factor (VEGF) pathways have shown significant clinical activity and in some cases have changed the standard of care for advanced NSCLC. In the past year, an unprecedented number of trials have been reported using agents targeting the EGFR (erlotinib, gefitinib, cetuximab), VEGF (bevacizumab) or the VEGF receptor (sorafenib, sunitinib, cediranib), and inhibitors of both pathways (vandetanib, erlotinib, or cetuximab plus bevacizumab). This review focuses on recently reported trials of targeted agents that have the potential to affect the treatment of patients with NSCLC.