Future directions in non-small cell lung cancer

Although chemotherapeutic regimens remain limited in activity against non-small cell lung cancer, some novel cytotoxic agents and radiotherapy techniques, alone or in combination, have shown promising advances. Numerous clinical trials have demonstrated increases in overall response rates, and some agents have shown additive or synergistic effects against tumor tissue. The cytoprotectant amifostine (Ethyol; Alza Pharmaceuticals, Palo Alto, CA/US Bioscience, West Conshohocken, PA) is being assessed for its protection of normal tissue against the toxic effects of chemotherapy and radiotherapy and for its potential role in enhancing the efficacy of these modalities. Protection from dose-limiting toxicities may allow dose escalation and improve the therapeutic index. Current and future investigations of novel agents and modalities, with or without cytoprotectants, should lead to better prognosis and prolonged survival rates.