The results of the many clinical trials published in 1997 had only modest impact on the treatment results using either
cytostatic agents alone or combined with
radiotherapy in
lung cancer. In SCLC,
combination chemotherapy including platin-compounds (
cisplatin,
carboplatin) and the podophyllotoxins (
etoposide and
teniposide) continue to be the cornerstone of
therapy. Complete plus partial responses to
combination chemotherapy occurs in 80-90% of all patients. Median survival is at present 11-17 months, and overall 5-year survival approximately 5% depending on the initial
tumor stage. The
duration of treatment has been shortened to 5-6 months. In relapsing patients
topotecan and
paclitaxel appear to have clinical useful activity. For epidermoid, adeno- and
large cell carcinoma further support has arisen for the use of preoperative and preirradiatory
chemotherapy in stage III NSCLC, but further studies are needed before specific recommendations can be given for general use. For patients with advanced NSCLC, new innovative treatments are still urgently needed. Platin-containing regimens with the inclusion of new agents, such as
gemcitabine, taxenes, and
navelbine, yielded response rates of 42-55% in phase II trials, but results from large phase III trials are necessary in order to measure the impact of these new agents in the management of NSCLC. Major improvements of
therapy for
mesothelioma have not occurred within the last year.