Chemotherapy for Advanced Non–Small-Cell Lung Cancer: Who, What, When, Why?

Bunn, Paul A. Jr

From the University of Colorado Cancer Center, Denver, CO.

Supported in part by grant nos. P30 CA46934-14 and P50 CA58187-08 S1 from the National Cancer Institute, Bethesda, MD.

Address reprint requests to Paul A. Bunn, Jr, MD, University of Colorado Cancer Center, 4200 E. 9th Ave, Box B 188, Denver, CO 80262; email: [email protected].

Journal of Clinical Oncology 20(18s):p 23s-33s, September 15, 2002.

Despite the poor survival of patients with advanced (stage IIIB with pleural effusion or stage IV) non–small-cell lung cancer, the introduction of new chemotherapeutic agents has improved survival and quality of life with reduced toxicity compared with older cisplatin-based therapies. Randomized trials support the use of two-drug combinations for patients of all ages with performance status of 0 to 1. These two-drug combinations should contain at least one new agent. Some of these two-drug combinations may be acceptable in selected patients with a performance status of 2. Newer, targeted therapies hold promise to improve outcome without adding a great deal of additional toxicity.