First-line combination chemotherapy for advanced non-small cell lung cancer: the Eastern Cooperative Oncology Group and Southwest Oncology Group experience.

Over the past 15 to 20 years we have seen small but significant improvements in the treatment of patients with advanced or metastatic non-small cell lung cancer. By the late 1980s the median survival had increased from approximately 4 months in the untreated patient to approximately 7 to 8 months with traditional cisplatin-based chemotherapy combinations. In the early 1990s several new agents, including the taxanes paclitaxel and docetaxel, gemcitabine, irinotecan, and vinorelbine, demonstrated activity in metastatic non-small cell lung cancer. The combination of cisplatin with some of these newer agents such as vinorelbine or paclitaxel in recent phase II trials resulted in median survivals of approximately 9 to 10 months. Some of these results have been confirmed in large multicenter phase III trials conducted by two US Cooperative groups; the Southwest Oncology Group and the Eastern Cooperative Oncology Group. Their contribution to progress in the treatment of non-small cell lung cancer is discussed.