[Chemotherapy of non-small-cell lung cancers]

Lung cancer is the major cause of cancer-related death in France among men and its incidence is increasing in women. Approximately 80% of lung cancers are of the "non-small cell" subtype (NSCLC) and surgery is the only curative treatment of this disease. Nevertheless, about 90% of patients will require a systemic treatment, either because of local invasion or a distant dissemination. Traditionally, NSCLC was considered to be a chemoresistant tumor and the role of chemotherapy was largely discussed. A recent meta-analysis on the role of chemotherapy in NSCLC included more than 9,000 patients: it demonstrated that cisplatin-based combinations provide a significant survival benefit in patients with inoperable NSCLC. New drugs such as vinorelbine, camptothecins, taxoids and gemcitabine are now available and can be used as single agents or in combination. Their activity should provide an increasing response-rate and a survival improvement in patients with metastatic disease. The combination of chemotherapy with radiation therapy and/or surgery also should increase both the complete response rate and cure rate in patients with limited disease.