Novel treatments in non-small cell lung cancer

Systemic therapy consisting of cytotoxic agents is the primary treatment for stage IV non-small cell lung cancer (NSCLC) patients who have a relatively good performance status. Although research has shown that patients treated with chemotherapy compared with supportive care only have shown modest survival improvements and that the newest chemotherapy regimens are slightly more effective than the older regimens, the 2-year survival rate for NSCLC patients with the most favorable prognostic factors is only approximately 15%. The results of large randomized trials suggest that a survival plateau has been reached using currently available chemotherapy doublets. Developing completely different treatment strategies involving noncytotoxic agents might improve the treatment of NSCLC. Recent developments in cell biology suggest that developing therapies directed at targets that provide growth and survival advantages for malignant cells might be a more effective way of treating neoplastic diseases. This article discusses novel, noncytotoxic agents for which there are clinical data in NSCLC.