Future directions in the treatment of non-small cell lung cancer

Five-year survival rates for patients with non-small cell lung cancer have changed only minimally over the past 20 years. Although systemic chemotherapy has not yet proved to be of major clinical value, suggestions of improving efficacy have been noted over the past decade. A small but real fraction of complete responses has been obtained with combination chemotherapy in patients with favorable prognostic characteristics. A few studies of adjuvant chemotherapy, given after surgery or in conjunction with definitive irradiation, have demonstrated improved disease-free or overall survival periods. Future approaches suggested by laboratory observations of tumor cell biology, such as identification of patients more likely to respond to chemotherapy and early detection of patients at high risk, to develop lung cancer, may eventually prove useful.