Neoadjuvant and adjuvant therapy of non-small cell lung cancer.
Present treatment options for non-small cell lung cancer in the adjuvant and neoadjuvant settings are far from ideal. The bottom line of improvement in overall survival by any treatment modality used has yet to be achieved. For this to happen, better drug therapy will be required. Future trials should be carefully designed with intraoperative staging and stratification of patients by histology, stage, and potentially immunologic markers, ploidy, and molecular biologic markers such as growth factors and their receptors. Combination of individual therapies to maximal toxicity in an attempt to overcome inherent tumor resistance will be key. The use of colony-stimulating factors, with high-dose chemotherapy integrated with hyperfractionated radiotherapy, may be seen in future studies. Combining standard chemotherapy and radiotherapy with cytokines or immunotherapy using interleukin-1 and -2, or tumor necrosis factor or monoclonal antibodies to growth factors may be seen in innovative trials. By such meticulously and intelligently designed trials, progress in adjuvant and neoadjuvant treatment of the important group of patients with locally advanced non-small cell lung cancer will occur.
Rose
L J
LJ
Department of Medicine, Thomas Jefferson University, Philadelphia, PA 19107.
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D006801:Humans; D007167:Immunotherapy; D008175:Lung Neoplasms / Q000473:pathology / Q000628:therapy*; D009367:Neoplasm Staging; D011879:Radiotherapy Dosage