Current chemotherapy of advanced non-small cell lung cancer

Systemic chemotherapy for patients with a good performance status and advanced non-small cell lung cancer may result in prolonged survival and improved quality of life. However, few single agents have an activity of more than 15% and they have significant toxicity. Cisplatin is widely regarded as the single agent of choice. Compared with single-agent therapy, two-drug combinations generally provide higher response rates although survival benefit is marginal. Three-drug combinations generally provide no additional efficacy benefit and are associated with greater toxicity. A cisplatin-based combination with one other agent provides the best currently available therapeutic index. Chemotherapy may also improve the patient's quality of life. The toxicity of current chemotherapy is an important factor and there is a clear need for new cytotoxic agents with equivalent or greater activity yet a more acceptable toxicity profile.