Chemotherapy in non-small cell lung cancer: results of recent trials

Several recent studies in non-small cell lung cancer (NSCLC) have helped to clarify the role of chemotherapy in patients with this disease. The objective of this communication is to briefly review some of the more important topics in the treatment of NSCLC. The more effective available combination regimens are based on single agents that have shown efficacy in phase II trials. Of additional importance is the use of the single agents in the same dosage and schedules in which the activity was originally reported. The question of the influence of chemotherapy on survival is discussed in terms of (1) the significant prognostic factors, including performance status, serum LDH level, and the presence of extrathoracic disease, including the influence of bone metastases, and (2) two recent trials comparing chemotherapy with supportive care in patients with unresectable NSCLC. Several recent trials have approached the question of preoperative or neoadjuvant chemotherapy in patients with advanced intrathoracic tumor. These trials have provided provocative results that indicate that combined modality approaches will continue to be interesting topics of clinical research in the near future.