Emerging therapies in non-small-cell lung cancer

Lung cancer remains the single most devastating cause of cancer-related death with approximately 1.5 million cases of lung cancer expected worldwide and more than 1.3 million cancer-related deaths in 2001. In the United States alone, of 164,100 news cases expected in the year 2000, about 70,000 will be metastatic disease (stage IV), and another 70,000 will be locally advanced (stages IIIA and IIIB). Therefore, the five-year survival rate for lung cancer has improved only incrementally from 5% in the late 1950s to 14% by 1994. While advances in combined modality therapy have led to significant progress against locally advanced disease, it was only a decade ago that few believed that the treatment of stage IV non-small-cell lung cancer was justifiable. However, multiple randomized trials in the 1980s and 1990s have changed the role of chemotherapy in lung cancer, such that by the middle of the next decade, it may be that only patients with stage IA non-small-cell lung cancer are not considered as candidates for chemotherapy.