The future beyond platinum for the treatment of advanced non-small cell lung cancer

The development of chemotherapy for advanced non-small cell lung cancer has been most productive in its fifth decade. We began this decade by establishing cisplatin-based combination chemotherapy regimens of the 1980s as effective at improving survival for patients with advanced disease. The observed improvement in survival from these trials appears to be primarily attributed to cisplatin. Furthermore, this decade, unlike the prior, has identified an abundance of novel active agents for the treatment of this disease. Vinorelbine, gemcitabine, docetaxel, paclitaxel, and irinotecan are all new chemotherapeutic agents which have shown promising activity and their cisplatin combinations have further advanced survival for these patients. In contrast to the cisplatin-based chemotherapy trials of the 1980s, these newer chemotherapeutic agents, when given in combination with cisplatin, add to the survival outcomes for patients with advanced non-small cell lung cancer. With these survival advances has come a focus on chemotherapy-induced adverse events, lung cancer symptom management, and overall quality of life. Is it feasible to use these novel chemotherapeutic drugs as single-agents, sequentially or as nonplatinum combinations to prolong survival, minimize adverse events, control symptoms, and improve the quality of life for patients with this disease? The goal of this symposium will be to present the results of the single-agent and nonplatinum combination studies of these newer therapies with a focus on survival, symptom management, and quality of life. This symposium is intended to introduce the next decade of care for advanced non-small cell lung cancer, namely "Non-platinum-Based Chemotherapy."