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Analysis of Adjuvant Chemotherapy in Non-Small Cell Lung Cancer

Author(s): Sinead Cuffe | Natasha B Leighl

Journal: European Journal of Clinical & Medical Oncology
ISSN 1759-8958

Volume: 2;
Issue: 2;
Start page: 41;
Date: 2010;
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Keywords: Adjuvant chemotherapy | lung cancer | non-small cell lung cancer | cisplatin | molecular markers

Lung cancer is the leading cause of cancer-related mortality in the developed world. The majority of patients with non-small cell lung cancer (NSCLC) present with advanced disease. Even in the one-third of patients presenting with early-stage disease, there is a high rate of relapse despite complete surgical resection. As most patients recur with distant metastases, it is hypothesized that micrometastases may be present at the time of surgery, suggesting a potential role for adjuvant chemotherapy. Postoperative cisplatin-based chemotherapy has been established as the standard of care in resected stage II–III NSCLC, improving 5-year survival by 8–15%. This review explores the evolution of adjuvant chemotherapy trials since the 1970s, charts what progress has been made to date, and analyzes the evidence leading to current standards of care. We also review some of the retrospective studies evaluating potential biomarkers in NSCLC and evaluate whether these may contribute to the heterogeneity of the chemotherapy response and assist in tailoring treatment. In addition, we review current studies of targeted therapy in the adjuvant setting and offer potential future directions for research.
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