Prise en charge des patients de Performans Status 2 atteints d'un cancer bronchique non à petites cellules métastatique

The treatment of fit patients (performance status 0-1) with metastatic stage of non-small cell lung cancer is well codified and consists in a doublet of platinum salt, preferably cisplatin, and third generation agent. On the other hand, treatment of performans status 2 patients who represent a non-negligible proportion of the whole population of patients with metastatic non-small cell lung cancer, is not so well defined. A first difficulty is due to the heterogeneity of this group of patients, as performans status 2 may be due to the extent of the disease but also to comorbidities. Second, performans status 2 patients are excluded from most of the clinical trials since 15 years. Finally appreciation of a performans status 2 is quite difficult and sometimes not reproducible. Nevertheless, it seems that those patients beneficiate from a doublet of carboplatin plus a third generation agent. For patients with EGFR mutations, treatment with TKI are as efficacious as in performans status 0-1 patients with quick improvement of the general condition.