Perspectives in adjuvant chemotherapy in NSCLC.
In 2007 the long-term outcome of lung cancer is still disappointing, with a 5-year survival rate not exceeding 15%. However, small but significant improvements in survival times have been achieved in the last decade. This progress has been achieved through the improvement of surgical techniques and following the introduction of more effective anticancer agents, mainly cisplatin in combination with newer agents (vinorelbine, taxanes, gemcitabine). The benefit of adjuvant chemotherapy in stage II-IIIA disease has been clearly demonstrated. Hints of some efficacy have also emerged for stage IB, while data on active adjuvant chemotherapy in stage IA, mostly from Japanese studies with oral uracil-tegafur, need to be confirmed in non-Asian patients. Optimal chemotherapy regimens and the role of targeted agents in the adjuvant setting are currently unknown. Increasing numbers of patients must be enrolled in adjuvant trials with a design based on pharmacogenomics profiles. Therefore, efforts should be directed toward the collection of surgical specimens to define biomolecular markers to select patients who will benefit from adjuvant treatments on an individual basis.
Selvaggi
Giovanni
G
University of Turin, Department of Clinical & Biological Sciences, Thoracic Oncology Unit, San Luigi Hospital, Regione Gonzole 10, 10043 Orbassano Torino, Italy. gselvaggi@inwind.it
Scagliotti
Giorgio Vittorio
GV