Update on First-Line Treatment of Non–Small Cell Lung Cancer

LISBON—Non–small cell lung cancer (NSCLC) accounts for some 80% of cases of lung cancer,1 which remains the leading cause of cancer death in the United States. Patients with NSCLC usually present with stage III or IV disease; because of the prevalence of advanced stage at presentation, end points for clinical studies include survival benefit, relief of symptoms, and quality of life (QOL) as well as tumor response rate. Research has shown that platinum-based chemoradiotherapy (ie, cisplatin) is the best option for stage III NSCLC, and platinum-based chemotherapy is most effective for palliation of stage IV disease. Despite the efficacy of platinum-based combination therapy for NSCLC, relapse rates remain high, and second-line treatment is an area of intensive research. Recent randomized Phase III trials have proved the efficacy of single-agent docetaxel for second-line chemotherapy in these patients. In TAX 317, docetaxel at 75 mg/m2 for stage IV disease increased overall survival, 1-year survival, time to disease progression, and QOL compared with best supportive care.2 Patients receiving docetaxel had less need for palliative radiotherapy. In TAX 320, docetaxel was compared with vinorelbine or ifosfamide for stage IV disease, with docetaxel given at a dose of BROUGHT TO YOU BY THE PUBLISHER OF