Intensity of neoadjuvant therapy in resectable non-small cell lung cancer

Induction chemotherapy prior to definitive local treatment improves the survival of patients with Stage III non-small cell lung cancer. Several strategies to improve on the impact of 2 or 3 cycles of conventional induction chemotherapy are under study. Immediate concurrent chemoradiation followed by surgery has been evaluated extensively in the Phase II setting. This approach is now the subject of a Phase III trial in North America. Increasing the number of induction chemotherapy cycles or using high dose chemotherapy with autologous stem cell support are other strategies currently under evaluation. Understanding whether either of these approaches will improve survival for patients with Stage III NSCLC must await future Phase III trials.