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Updated: Feb 5, 2026

Orthotopic Transplantation of Syngeneic Lung Adenocarcinoma Cells to Study PD-L1 Expression
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Published on: January 19, 2019

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First-Line Therapies for Metastatic Lung Adenocarcinoma Without a Driver Mutation

J Nicholas Bodor1, Vineela Kasireddy1, Hossein Borghaei1

  • 1Fox Chase Cancer Center, Philadelphia, PA.

Journal of Oncology Practice
|September 13, 2018
PubMed

Insights

For advanced non-small-cell lung cancer without driver mutations, new immunotherapy and chemotherapy combinations offer improved treatment options beyond traditional chemotherapy. This review guides selecting the best first-line therapy for these patients.

Area of Science:

  • Oncology
  • Medical Research
  • Clinical Trials

Background:

  • Lung cancer is a leading global cause of cancer death, with non-small-cell lung cancer (NSCLC) being the most prevalent type.
  • Adenocarcinoma is the most common NSCLC subtype, frequently diagnosed at advanced stages requiring systemic therapy.
  • While targeted therapies benefit a subset of patients with driver mutations, many lack these actionable targets.

Purpose of the Study:

  • To review current first-line systemic therapies for metastatic lung adenocarcinoma lacking driver mutations.
  • To provide a recommended treatment algorithm for selecting optimal first-line therapy.
  • To discuss emerging immunotherapy and immunochemotherapy combinations.

Main Methods:

  • Literature review of clinical trials and treatment guidelines.
  • Analysis of current therapeutic options for metastatic lung adenocarcinoma.
  • Development of a treatment selection algorithm.

Main Results:

  • Platinum-based chemotherapy remains a standard treatment.
  • Immunotherapy has emerged as a viable option, showing durable responses in some patients.
  • Novel immunotherapy and immunochemotherapy combinations show promise for expanding treatment benefits.

Conclusions:

  • Treatment selection for metastatic lung adenocarcinoma without driver mutations is evolving.
  • Immunotherapy and combination strategies may improve outcomes for a broader patient population.
  • A structured approach is needed to guide first-line therapy choices.

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