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

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

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: paul.bunn{at}uchsc.edu

ABSTRACT: 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.

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