Therapeutic options for the treatment of small cell and non-small cell lung cancer.

Although much of the excitement over pending advances in molecular biology may apply to therapy for non-small cell lung cancer, the practicing oncologist will still be faced with current treatments for the next several years. Little new research in the area of small cell lung cancer was reported, although the issue of consolidative chest irradiation appears to be resolved in favor of its use. To date, more chemotherapy is not better for small cell lung cancer. Treatment of non-small cell lung cancer remains difficult, although there are clear indications that chemotherapy with radiation is superior to radiation alone. Chemotherapy for non-small cell lung cancer advanced only marginally; several promising agents are just now coming into phase III trial in combination with established agents. Neoadjuvant therapy remains a confused arena, with a potpourri of different regimens and approaches combined with a nonstandardized approach to staging. Therapy for malignant pleural effusions also remains difficult, with even the best agent demonstrating a 30% to 40% treatment failure rate.