The benefits of achieving stable disease in advanced lung cancer

The cytostatic, molecular-targeted therapies becoming available for lung cancer and other human solid tumors are more likely to result in stable disease than to produce tumor regression. In the setting of advanced lung cancer, stable disease provides significant benefit to the patient. However, in the context of clinical trials, stable disease is vaguely defined, difficult to measure, and may represent a heterogeneous patient population. The inclusion of alternative trial end points such as symptom improvement and biologic activity may help to identify patients who have achieved clinically relevant stable disease. The epidermal growth factor receptor-tyrosine kinase inhibitor gefitinib (Iressa) has been shown to produce partial responses and stable disease in patients with advanced lung cancer who have previously received treatment with standard chemotherapies. In the monotherapy trials of gefitinib, stable disease was correlated with improvements in disease-related symptoms and quality of life--the most meaningful end points for the patient with advanced lung cancer. Thus, with the introduction of new molecular-targeted agents, stable disease with clinical benefit should become an important goal of anticancer therapy.