Survival improvement in thoracic cancer: progress from the last decade and beyond

Lung cancer remains a major concern, being the most common cancer worldwide, and with the incidence continuing to increase in many countries. Survival following diagnosis of non-small cell lung cancer (NSCLC) remains relatively low, with 1-year overall survival being approximately 25%. However, the development of new drugs and innovative treatment approaches is improving the outlook for patients with NSCLC. Important contributions have been made to the treatment of NSCLC and continue to do so with the development of gemcitabine, and more recently, pemetrexed. Major advances in the understanding of cancer biology have identified many potential targets for rationally designed novel therapies. Many of these targets are components of signalling pathways or metabolic processes that contribute to one of the hallmarks of the cancer phenotype. The novel targeted therapy enzastaurin, which is a derivative of the prototypical protein kinase C inhibitor staurosporine, is currently being investigated as monotherapy in NSCLC following first- or second-line chemotherapy. Research into the use of pharmacogenomics to tailor therapy to the individual patient is another innovative field that is yielding promising results that may help to improve the clinical outcome for patients with NSCLC in the future.