Postoperative and Preoperative Chemotherapy for Non-Small Cell Lung Cancer

BACKGROUND: Few randomized trials of preoperative and postoperative adjuvant systemic therapy have been performed in patients with non-small-cell lung cancer (NSCLC). METHODS: The authors reviewed the recent literature on comparative trials and meta-analyses to determine the current status of adjuvant therapy for patients with NSCLC. RESULTS: Postoperative adjuvant therapy with cisplatin-containing regimens reduces the risk of death by 3% at two years and by 5% at five years. Preoperative therapy can clear tumor in the resected specimen in approximately 15% of cases, and two small trials report substantial survival benefit. CONCLUSIONS: The development of new and more active regimens for NSCLC may provide the biologic basis for clinical trials to demonstrate more pronounced benefit for adjuvant systemic therapy.