First-line combination chemotherapy for advanced non-small cell lung cancer: the Eastern Cooperative Oncology Group...

Over the past 15 to 20 years we have seen small but significant improvements in the treatment of patients with advanced or metastatic non-small cell lung cancer. By the late 1980s the median survival had increased from approximately 4 months in the untreated patient to approximately 7 to 8 months with traditional cisplatin-based chemotherapy combinations. In the early 1990s several new agents, including the taxanes paclitaxel and docetaxel, gemcitabine, irinotecan, and vinorelbine, demonstrated activity in metastatic non-small cell lung cancer. The combination of cisplatin with some of these newer agents such as vinorelbine or paclitaxel in recent phase II trials resulted in median survivals of approximately 9 to 10 months. Some of these results have been confirmed in large multicenter phase III trials conducted by two US Cooperative groups; the Southwest Oncology Group and the Eastern Cooperative Oncology Group. Their contribution to progress in the treatment of non-small cell lung cancer is discussed.