Title:Systemic Treatment of Chest Tumors: Highlighting Some Differences Between Eastern and Western Countries
Volume: 14
Issue: 2
Author(s): Victor HF Lee*Dora L.W. Kwong
Affiliation:
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pok Fu Lam,Hong Kong
Keywords:
Chest tumors, mutations, targeted therapy, multidisciplinary management, overview.
Abstract: Introduction: Malignant chest tumors are common tumors in humans.
Among them, lung cancer including Non-Small-Cell Lung Cancer (NSCLC) and smallcell
lung cancer are the most common types. Surgery alone for early-stage, or in combination
with chemotherapy and radiation therapy for more advanced disease have been
the major components of treatment strategies for the past few decades. The recent discovery
of oncogenic drivers for NSCLC has led to the devise of new targeted therapies
which dramatically improve the quality of life and survival of patients whose tumors
harbor such mutations. New generations of targeted therapy which specifically target the
drug-resistant mutations gradually evolve, benefiting patients who are refractory or intolerant
to first-line targeted therapy. The survival of NSCLC patients without identifiable
mutations has also improved, as contributed by use of the relatively non-toxic
chemotherapeutic and anti-angiogenic agents, as well as the advances of radiation techniques
with better tumor coverage and reduced toxicities. The treatment outcomes of
other rarer chest tumors including mesothelioma, thymic epithelial tumors and neuroendocrine
tumors have also improved significantly, secondary to earlier detection, more
accurate and uniform diagnostic criteria and classification, emergence of new treatment
options and multidisciplinary management. In addition, the epidemiology, patterns of
genetic and environmental predisposition and treatment strategies of these tumors may
differ substantially between Western and Asian countries.
Conclusion: The approaches of this review are to highlight the recent management advances
and contrast the differences of treatment practice between Western and Asian
countries.
