In
small cell lung cancer,
combination chemotherapy including
platinum compounds (
cisplatin and
carboplatin) and the podophyllotoxins (
teniposide and
etoposide) continues to be the backbone of
therapy. Complete plus partial responses to
combination chemotherapy occur in 80-90% of all patients. Median survival is at present 11-17 months depending on the initial tumour stage. Overall 5-year survival is approximately 5%. The
duration of treatment has been shortened to 5-6 months. The results of the use of hematopoietic
growth factors have hitherto been disappointing with respect to survival, while a definite effect on the degree and number of
infections has been documented, when aggressive
chemotherapy is administered. For epidermoid-, adenoid- and
large cell carcinoma, results are emerging indicating that preoperative and preirradiatory
chemotherapy in stage IIIa
non-small cell lung cancer might have a substantial role in the overall management based on results from phase III trials. The studies are, however, rather modest in number and longer follow-up is necessary before recommendations for general use can be made. For patients with advanced
non-small cell lung cancer (stage IIIb and IV), meta-analyses have yielded a small survival benefit (6 weeks) in favour of patients receiving
chemotherapy vs. best supportive care. The treatment of this type of NSCLC should, however, still be considered to be experimental in order to define new innovative treatments. No improvement of the
therapy of
mesotheliomas has been reported.