[Developed new agents for lung cancer]

Platinum-based chemotherapy is considered to be the standard chemotherapy of non-small cell lung cancer (NSCLC) at present. New agents such as irinotecan, paclitaxel, docetaxel, vinorelbine, gemcitabine, topotecan, and amurubicin were developed in the 1990s. Combination chemotherapy using new agents improved survival rates compared with the classic regimen. Irinotecan, paclitaxel, docetaxel, vinorelbine, and gemcitabine have been confirmed to be effective against NSCLC. However, chemotherapy for NSCLC is controversial because the differences in the efficacies of combination chemotherapies including new agents have not been recognized in randomized controlled trials. The Four-Arms Cooperative Study is an ongoing postmarketing clinical trial in Japan. The a ntitumor agents irinotecan, topotecan, paclitaxel, and amurubicin have been confirmed to be effective in small cell lung cancer (SCLC). The combination of etoposide and cisplatin (PE) is the standard regimen for SCLC in Western countries. However, the combination of irinotecan and cisplatin (CP) resulted in higher response rates and better median survival times than PE for extensive-disease SCLC in a JCOG trial. At present, CP is considered to be the standard chemotherapy regimen to treat SCLC in Japan. The development of new agents, particularly molecular target-based drugs and multimodality treatment, is necessary to improve the therapeutic results in lung cancer further.