[Therapy of bronchus carcinoma: therapeutic possibilities and current molecular biology trials]

Clearcut progress has been achieved in the treatment of lung cancer in the last decade. While small cell lung cancer has proven a highly chemosensitive tumor, only remissions of relatively short duration are obtained. The high relapse rate is probably due to the reappearance of chemoresistant subclones. In contrast, non small cell lung cancer is often chemoresistant from the outset, a fact which limits the therapeutic possibilities in these tumors. Different forms of chemoresistance are described and potential modalities of circumventing or reversing it are discussed. In recent years, greater insight into molecular mechanisms of tumor formation has been achieved. The role of activation or overexpression of oncogenes has been demonstrated. More recently the role of tumor suppressor gene inactivation has become evident. By means of restriction fragment length polymorphism (RFLP) a combination of gene deletions in various chromosomes has been demonstrated in lung cancer. The pattern of chromosomes involved appears to vary between small cell and non small cell lung cancer. It is to be hoped that these new insights will be translated into new treatment modalities for lung cancer.