[What choice of first-line treatment?]

Treatment of advanced non-small cell lung cancer has evolved last years, until an individualized approach, notably according to patient characteristics, histology, and molecular profile of the tumor. So, the presence of EGFR mutations allows the administration of gefitinib in first line, with response rate around 70% and a progression-free survival around 12 months. If there is no EGFR mutation, the treatment consists in cytotoxic chemotherapy, according to histology. Indeed, non squamous carcinomas are accessible to a platin-pemetrexed doublet, and squamous carcinomas to another platin-based doublet. Besides, new molecular targets are identified, with corresponding targeted treatment. So, the EML4 - ALK translocation is accessible to a treatment by crizotinib, with response rate around 60-70%.