Irinotecan/Taxane combinations in advanced non-small-cell lung cancer

Although conventional therapies can produce median survival times of 8 months to 1 year in non-small-cell lung cancer (NSCLC) patients, there is still much room for improvement. With the emergence of multiple new agents, there is an increased number of therapeutic options available. Irinotecan has demonstrated activity in small-cell lung cancer and promising overall response rates of up to 35% as a single agent in NSCLC. Irinotecan/paclitaxel is currently being tested in a phase II trial with encouraging preliminary results. The triplet irinotecan/carboplatin/paclitaxel has been tested in a phase II trial as well. This triplet combination has yielded an impressive median survival time of 12.5 months and a 1-year survival rate of 50%, suggesting that this treatment regimen should be further explored. When used in combination with docetaxel, irinotecan has demonstrated comparable survival and response rates to the conventional cisplatin/docetaxel doublet but with lower toxicities. Ongoing and future trials will further clarify the role of irinotecan/taxane combinations in the treatment of NSCLC, both in treatment-naive patients and in the second-line setting.