New insights in drug development for the non-small cell lung cancer therapy

Non-small cell lung cancer (NSCLC) remains a major problem worldwide. Since most patients with NSCLC have advanced disease at diagnosis, to date, chemotherapy, with third-generation platinum-based doublets, represents the standard of care. However, a plateau has been reached with the use of cytotoxic chemotherapy in advanced NSCLC. Advances in the knowledge of tumour biology and mechanisms of oncogenesis have granted the singling out of several molecular targets for NSCLC treatment. To date, erlotinib and gefitinib, epidermal growth factor receptor tyrosine kinase (EGFR-TK) inhibitors have been licensed, erlotinib worldwide and gefitinib in Asian countries, for refractory NSCLC. Currently, bevacizumab, an anti-vascular endothelial growth factor (VEGF) monoclonal antibody, is the only clinically available antiangiogenic agent licensed, in combination with carboplatin plus paclitaxel, for first-line therapy of advanced NSCLC patients in the United States. Several new biologic agents are being evaluated in clinical research and some of them, such as ZD6474, sorafenib and sunitinib, due to the reported preliminary results and the oral administration seem to be promising targeted agents for the treatment of NSCLC. Aim of this review is to discuss about the new insights in targeted agents development for the treatment of NSCLC patients.