The combination of etoposide and cisplatin in non-small-cell lung cancer (NSCLC)

The role of chemotherapy in the treatment of advanced non-small-cell lung c ancer (NSCLC) has been a subject of debate for many years. Only recently, c isplatin-based combination chemotherapy has been demonstrated to yield a sm all but definite survival benefit and to improve symptoms, performance stat us and quality of life in a substantial proportion of advanced NSCLC patien ts. The cisplatin-etoposide (PE) regimen was developed in the early 1980s a nd has been one of the standard chemotherapy programs most extensively used in the clinical practice until a few years ago. More recently, several ran domized trials have compared the efficacy of new cisplatin-containing combi nation chemotherapies including Paclitaxel or Gemcitabine with that of PE o r PE-like regimens. Preliminary results are encouraging, indicating a small benefit in favor of the last generation of regimens which might therefore replace PE as 'gold standards' in the treatment of advanced NSCLC. However, the costs of these last generation regimens is higher and the entity of th e benefit small. Therefore, PE chemotherapy can still be an option in selec ted situations.