Adjuvant therapy for lung cancer

To improve outcome of patients with lung cancer, the leading cause of cancer mortality worldwide, a multidisciplinary approach is required. Only approximately 30% of all lung cancer patients present with early stage disease (IA-IIIA). For non-small cell lung cancer (NSCLC) complete surgical resection is currently considered to be the optimal treatment, but high rates of recurrence even after complete resection require to investigate regimes of additional therapy. In the last years, evidence for adjuvant chemotherapy in stage II and III of NSCLC was shown, supported by large clinical trials and meta-analyses, while for stage IB disease the role of adjuvant chemotherapy remains controversial. Further there is actually no evidence to support the routine use of adjuvant radiation or radio-chemotherapy in completely resected patients. For small cell lung cancer (SCLC) a multimodality adjuvant approach is feasible in early stages, his definitive value however should be evaluated in further randomized trials. Current efforts are directed toward identification of prognostic and predictive markers to individualize treatment stratification, a realistic goal for the future. The current status and future perspectives of adjuvant therapy in lung cancer are reviewed in this manuscript.