[Therapeutic strategy for advanced non-small cell lung cancer]

This paper describes the recent progress in the treatment of advanced non-small cell lung cancer (NS CLC) as follows: 1) The results of single agent chemotherapy in NSCLC, particularly development of new drugs, are summarized. CPT-11, taxol, taxotere, vinorelbine and gemcitabine have appeared to have a response rate of more than 20%. In addition results of phase I and II trials that involved these agents as part of combination regimens are presented. 2) We summarize 8 randomized trials of combination chemotherapy compared with best supportive care. These studies have provided that combination chemotherapy modestly improves survival of patients with advanced NSCLC. 3) Although several randomized trials with adjuvant or neoadjuvant chemotherapy have reported in the patients with locally advanced NSCLC, we have still not confirmative results. 4) Cisplatin based combination chemotherapy followed by chest irradiation improves outcomes of the patients with stage IIIA or IIIB unresectable NSCLC as compared with chemotherapy alone or radiation therapy alone. In spite of these advances further investigations are necessary to improve the treatment results of patients with advanced NSCLC.