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Lung Cancer Highlights

Massachusetts General Hospital Cancer Center, Boston, Massachusetts, USA

Correspondence: Thomas J. Lynch, Jr., M.D., Massachusetts General Hospital Cancer Center, Hematology-Oncology Department, Room 201 Cox Building, 100 Blossom Street, Boston, Massachusetts 02114-2617, USA. Telephone: 617-724-1136; Fax: 617-724-3166; e-mail: lynch.thomas{at}mbh.harvard.edu

Have we made any progress in the treatment of advanced non-small cell lung cancer (NSCLC) over the past 15 years? After hearing the Eastern Cooperative Oncology Group (ECOG) 1594 presented by Dr. Joan Schiller at the plenary session of the 36th Annual Meeting of ASCO, it is hard to be certain. Schiller reported the results of one of the world's largest randomized trials in metastatic lung cancer comparing four platinum-based doublets. There were no differences in survival (primary endpoint) or response between these four regimens, although the cisplatin/gemcitabine arm had a superior time to progression. In her commentary on this study, Dr. Francis Shepherd concluded that progress in the treatment of metastatic lung cancer has occurred at "a snail's pace."

Despite the disappointing results of ECOG 1594, there were notable trials describing new agents with novel mechanisms of action reported at this year's ASCO meeting. In small-cell lung cancer, the combination of cisplatin/ irinotecan was found to be superior to cisplatin/etoposide. For NSCLC, novel agents Iressa anti-epidermal growth factor receptor tyrosine kinase and anti-vascular endothelial growth factor monoclonal antibody appear promising.

Key Words. Small cell lung cancer • Non-small cell lung cancer • Treatment • Metastatic disease

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