Focus on maintenance therapy in non-small-cell lung cancer

A major area of controversy in the management of advanced non-small-cell lung cancer (NSCLC) is the role of maintenance therapy. Widely used in the treatment of other solid tumors and hematologic malignancies, maintenance therapy has become a treatment paradigm also for advanced NSCLC only recently due to the introduction in clinical practice of more tolerable drugs, such as pemetrexed, bevacizumab or erlotinib and on the basis of clinical data coming from large Phase III randomized trials. In particular, the rationale for maintenance therapy in NSCLC is based on the evidence that patients whose disease responds to initial treatment may benefit from maintenance therapy if the physician drops the platinum drug after four to six cycles. The terminology around this issue is quite confusing and meaningless; however, we distinguish at least two types of maintenance therapy: continuation maintenance and switch maintenance.

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