Nonplatinum-Based Chemotherapy for Advanced Non-Small Cell Lung CancerMok, Tony S. K. MD, FRCPC; Chan, Anthony T. C. MD, FRCPClinical Pulmonary Medicine: May 2003 - Volume 10 - Issue 3 - p 143-153 doi: 10.1097/01.cpm.0000059369.04504.d5 COLLEAGUES IN RESPIRATORY MEDICINE Buy Abstract In Brief Author InformationAuthors Article MetricsMetrics The new generation of cytotoxic drugs, such as gemcitabine, docetaxel, paclitaxel, vinorelbine, and irinotecan, plays an crucial role in the management of advanced non-small cell lung cancer. Single-agent therapy has been shown to palliate symptoms, improve quality of life, and defer radiotherapy, but does not necessarily prolong survival in chemotherapy-naïve patients. On the other hand, single-agent docetaxel may prolong survival when given as second-line therapy in patients who have failed platinum-based regimens. Many phase II studies have demonstrated that the gemcitabine- or taxane-based nonplatinum combinations are highly effective in the induction of tumor response and are able to attain survival prolongation. Two published randomized phase III studies comparing nonplatinum-based to platinum-based chemotherapy have reported equal efficacy, but interim results from two other ongoing comparative studies have suggested the nonplatinum-based regimens to be inferior. The current available data do not necessarily support general use of nonplatinum-based regimens in patients with advanced non-small cell lung cancer, but selected patients may benefit. Platinum-based combination chemotherapy is the current standard of treatment for advanced non-small cell lung cancer. A new generation of cytoxic drugs may potentially achieve the same objective of survival prolongation with less toxicity. This article reviews clinical trials that study the efficacy of nonplatinum-based chemotherapy and define their role in the management of advanced non-small cell lung cancer. From the Department of Clinical Oncology, The Chinese University of Hong Kong, Hong Kong, China. Address correspondence to: Tony S. K. Mok, MD FRCPC, Department of Clinical Oncology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China. Address e-mail to: firstname.lastname@example.org © 2003 Lippincott Williams & Wilkins, Inc.