Cooperative group research efforts in lung cancer: focus on early-stage non-small-cell lung cancer

Many of the most significant advances in the treatment of lung cancer have come from trials run within the cooperative group system. The leaders of the lung cancer section of each group interact throughout the year, but an annual lung cancer congress in Hawaii provides a forum for extensive discussions of ongoing and planned trials. This article is the first in a series that will focus on the key points of this discussion held at the 8th Annual Lung Cancer Congress in June 2007. Early-stage non-small-cell lung cancer trials are highlighted in this manuscript. Current work in adjuvant therapy is focused on exploring the use of bevacizumab in addition to chemotherapy for resected disease in a large Intergroup study and the use of more "personalized" chemotherapy based on specific genomic or protein expression profiles of individual tumors in smaller exploratory studies. The question of postoperative radiation therapy is being addressed within the cooperative groups. Alternative approaches to surgery, such as lesser resections in smaller tumors and accelerated radiation including stereotactic radiosurgery, are also under investigation within this framework. Ongoing trials within the cooperative groups continue to drive steady improvement in the treatment of lung cancer and offer great promise for the future.