The current status of adjuvant chemotherapy for resected non-small cell lung cancer

Surgery remains the mainstay of treatment in early stage non-small cell lung cancer. However, a significant percentage of patients relapse and die following surgical resection, mainly due to systemic relapse. Adjuvant chemotherapy has been evaluated in this setting; however, the role of cisplatin-based adjuvant chemotherapy following surgical resection remains controversial. Two recent reviews of the cisplatin-based adjuvant chemotherapy experience in non-small cell lung cancer are discussed. Although not definitive, these reviews are suggestive of a possible treatment effect regarding postoperative adjuvant cisplatin-based chemotherapy. The cumulative experience in this setting is notable for small numbers of heterogenous patient populations, substandard chemotherapy regimens, inadequate chemotherapy delivery, and lack of statistical power in individual trials to detect small but clinically meaningful differences in survival. Recently completed and ongoing trials of adjuvant chemotherapy in resected non-small cell lung cancer are reviewed.