Advanced NSCLC can present with symptoms of lung cancer due to metastasis. These symptoms are cough, dyspnea, hemoptysis and weight loss. Patients with advanced malignant pleural effusion may present with pleural effusion only. Patients are often asymptomatic and only seen in the context of a CT study for metastatic disease.
A number of environmental factors have been related with the development of advanced NSCLC. For instance, exposure to asbestos, chemical fumes of the industrial environment and cigarette smoking increase the risk of developing advanced NSCLC.
247,000 people per year are diagnosed with advanced [non small cell lung cancer](https://www.withpower.com/clinical-trials/non-small-cell-lung-cancer) (nsclc) in the United States, which makes it the most common cancer in American women.
Inclusion in current trials is required for treatment advancement. Most of these studies lack a control arm and have low response rates. Current treatments for patients with advanced NSCLC may have less than a 30% response rate and are associated with significant morbidity. Overall, there is little meaningful evidence for any treatment that can reliably improve clinical outcomes in lung cancer with metastases. A new approach that uses systemic therapy to eradicate micrometastases is the best treatment option in patients with advanced NSCLC.
Results from a recent clinical trial shows that advanced tumours are not always incurable, especially when they have metastasized. For NSCLC in particular, a cure for all patients is possible by using adjuvant therapies. The role of molecular profiling to select patients for adjuvant therapy and the role of neoadjuvant therapy for patients with good pathological response remain open questions that need to be answered in randomised studies.
[non small cell [lung cancer](https://www.withpower.com/clinical-trials/lung-cancer)](https://www.withpower.com/clinical-trials/non-small-cell-lung-cancer) is a fatal and highly chemo-resistant cancer that usually develops in never or current smokers. However it is very frequently detected due to non-specific clinical symptoms. Survival in individuals with lung cancer remains poor compared to individuals in general population of the same age. Mortality is mainly depending on stage, comorbidities, smoking status and treatment with chemotherapy agents. The aim of this article is to summarize the pathophysiology, clinical features and treatment options of NSCLC.
Nivolumab is frequently used in combination with other treatments in NSCLC. These combinations offer a substantial number of potential combinations with potential improved disease control in NSCLC, which are typically not explored in this context of the clinical setting.
There are no recent changes in treatment for advanced NSCLC. The discovery of the epidermal growth factor receptor (EGFR) as a target for treatments for advanced NSCLC may lead to improvements in survival for patients with advanced NSCLC.
The most commonly reported Side Effects of nivolumab treatment were Skin reactions, fatigue, itchiness, dizziness, decreased appetite, pain and sore throat. No significant changes in any of the haematology parameters investigated in this study. Although no clinically significant changes in blood pressure or cardiac function occurred during the course of nivolumab monotherapy treatment in the studied population, patients should continue to closely monitor these parameters.
Nivolumab in combination with platinum based neoadjuvant chemotherapy and concurrent chemoradiotherapy in stage III-IV NSCLC is tolerable and improves HRQoL when compared with chemotherapy alone.
Nivolumab is an effective treatment for advanced NSCLC, as demonstrated by the results of this clinical trial. Although more than 50% of patients have objective responses to nivolumab, almost all patients experience some increase in tumor size. These patients have a high rate of progressive disease at the time of nivolumab discontinuation (mean cumulative incidence of progressive disease = 41%). Patients should expect that nivolumab will delay the disease progression before their disease progresses. Physicians should be aware of this risk if patients are contemplating treatment with this therapeutic.
[Tobacco is a significant risk for most of the advanced non small cell lung cancers (nsclc). Tobacco use is the major cause of advanced non small cell lung cancers (nsclc) globally, we therefore need to take tobacco use as a significant risk factor of advanced non small cell lung cancer (nsclc). (J. J. Tissier's research, 2016)]