Irinotecan Combined with Radiation Therapy for Patients with Stage III Non-Small-Cell Lung Cancer: Current Trials

The prognosis for non-small-cell lung cancer (NSCLC) patients remains poor, with a high percentage of patients presenting with advanced disease and metastases. Thus, the therapeutic goal is to provide optimal local control and to eradicate any metastases. The advent of novel therapies has provided new hope in the treatment of this disease. Irinotecan, a topoisomerase I inhibitor, is active in both chemotherapy-naive and previously treated NSCLC patients. In addition, its ability to act as a radiosensitizer makes it a promising candidate for use in combined modality therapy. Encouraging response rates have been achieved in multiple trials using irinotecan alone or in combination with cisplatin, carboplatin, docetaxel, and/or radiotherapy. Further phase II and III studies should clarify the benefit of combined modality therapy as well as the optimal way to integrate radiotherapy into irinotecan regimens.