New treatment agents for advanced small cell and non-small cell lung cancer

The cure rate for lung cancer remains low (13%) primarily due to early systemic spread and the inability to cure systemic disease. These facts have led to pessimism regarding the role of chemotherapy, especially in non-small cell lung cancers. However, recent randomized trials demonstrated that chemotherapy significantly prolongs survival in advanced (stages IIIB and IV) and locally advanced (stages IIIA and IIIB) non-small cell lung cancers. Paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) is an active agent in both non-small and small cell lung cancers, producing objective response rates as high as any other active agent. Early combination studies show even higher response rates when paclitaxel is combined with cisplatin or carboplatin. Ultimately, randomized trials will be needed to define the optimal use of paclitaxel and other recently developed new agents in lung cancer.