The expanding role of cisplatin in the treatment of non-small-cell lung cancer.

Cisplatin has been employed in the treatment of non-small-cell lung cancer (NSCLC) since the late 1970s. Current evidence suggests that it may be the most effective single drug for the treatment of NSCLC patients. The overall response rate as a single agent is 21%, though responses are higher in previously untreated patients given high doses. Cisplatin combinations are the most effective therapy for advanced NSCLC. Two-drug combinations with a vinca alkaloid or etoposide consistently provide the best overall survival with acceptable toxicity. These two-drug combinations improve survival by 7 to 17 weeks compared with no chemotherapy. Cisplatin-based combinations improved survival by a greater degree in locally advanced patients (Stages IIIA and IIIB) when given with chest radiotherapy. There is evidence that cisplatin-based combinations also prolong survival when given after surgery for resected stage II and IIIA patients. In summary, cisplatin-based chemotherapy regimens are the preferred systemic therapy for NSCLC patients and prolong survival to a small degree.