Approximately 1.6 million new cases of
lung cancer are diagnosed each year throughout the world. In many countries, the mortality related to
lung cancer continues to rise. The outcomes for patients with all stages of
lung cancer have improved in recent years. The use of systemic
therapy in conjunction with local
therapy has led to improved cure rates in both resectable and unresectable patient groups. For patients with advanced stage disease, modest but real improvements in overall survival and quality of life have been achieved with systemic
chemotherapy. A major focus of research has been the development of molecularly targeted agents and the identification of
biomarkers for patient selection. Patients with
non-small cell lung cancer with mutations in the
epidermal growth factor receptor (EGFR)
tyrosine kinase domain achieve response rates of greater than 70% and superior progression-free survival when treated with an EGFR
tyrosine kinase inhibitor compared with standard
chemotherapy. This has now emerged as the preferred therapeutic approach for the subset of patients with a mutation in exons 19 or 21 of the EGFR. Another promising targeted approach involves the use of an
anaplastic lymphoma kinase (ALK) inhibitor in patients with a translocation involving the echinoderm
microtubule-associated protein-like 4 (EML4) and -ALK genes. Finally, a paradigm shift in favor of maintenance
therapy for patients with advanced stage disease has gained strength from recent data. All of these advances have been made possible by developing a greater understanding of the biology, the discovery of novel
anticancer agents, and improved supportive care measures. This article reviews the major strides made in the treatment of
lung cancer in the recent past.