Treatment standards exist for each stage of non-small cell lung cancer (NSCLC). The American Society for Clinical Oncology, among others, has developed guidelines for the treatment of unresectable NSCLC. This does not mean, however, that adequate treatment options are available for the majority of patients today. Experience shows the limitations of treatment and that improvement in this area is urgently needed.
For advanced stage disease, this applies to first-line as well as second-line therapy, even though new options are (Alimta) or are likely to be available soon (Tarceva). For earlier stages of NSCLC, improvements are needed in the results of local treatment options (surgery, radiotherapy) within multi-modal treatment concepts that include systemic therapy. Over the past 2 years, adjuvant therapy has emerged as a new standard for patients with resectable NSCLC. Patients with localized NSCLC who cannot undergo surgery but are otherwise in good general health should receive combined chemotherapy and radiotherapy instead of radiotherapy alone, and chemo/radiotherapy should be administered concurrently. The limitations of these treatment strategies are clear, however, and improvement is urgently needed.