Gemzar platinum combinations: phase III trials in non-small cell lung cancer

Lung cancer accounts for about 28% of all cancer-related deaths. Non-small cell lung cancer (NSCLC) constitutes 80% of all lung cancer cases, and in 70% of patients, the disease is diagnosed when it is locally advanced or metastatic. In these situations, chemotherapy has played only a minor role in modifying the natural history according to a 1995 meta-analysis. New drugs such as gemcitabine, vinorelbine, and the taxanes have been combined with cisplatin and tested in several phase-II and phase-III clinical trials versus cisplatin alone and different cisplatin/new drug combinations. Overall, the data seem to confirm that, despite a possible increase in response rate, no major difference in long-term survival has been achieved. Moreover, toxicity and cost may be significant with some of the combinations and schedules. While the combination of cisplatin and gemcitabine seems to be fairly active and better tolerated, we all look forward to the results of ongoing studies on the association of these regimens with the new biological drugs.