New combinations in the treatment of lung cancer: a time for optimism.

Strides have been made in the treatment of lung cancer in the last decade that warrant a more optimistic outlook toward the disease. The recent development of several new agents with single-agent activity, including paclitaxel, docetaxel, vinorelbine, gemcitabine, and irinotecan, is important, and those agents offer even greater potential when they are used in combination chemotherapy regimens or in combined-modality programs. The experience to date with therapy results with these agents in the treatment of lung cancer is reviewed and is compared to results documented with the current standard treatments for lung cancer, namely, cisplatin and cisplatin-based combination regimens. Published and ongoing trials are outlined, and directions for future research and the future goals of lung cancer therapy are outlined. The availability of newer chemotherapeutic agents that are active in lung cancer has led to response rates as high as 40% in the treatment of non-small cell lung cancer. These drugs have been shown to be active in combination drug regimens as well as when combined with radiotherapy. Future research will focus on using these agents in two- and three-drug regimens as radiation sensitizers and in combination programs with new drugs and biological agents with apparent activity against this disease.