• Akira Ono and Nobuyuki Yamamoto.
• Division of Thoracic Oncology, Shizuoka Cancer Center, Nagaizumi-cho, Sunto-gun, Shizuoka, Japan.
• Gan To Kagaku Ryoho. 2008 Sep 1; 35 (9): 1475-81.

AbstractCombination therapy with platinum preparations still occupies a central position in chemotherapy for lung cancer. Third-generation regimens that combine an anticancer drug and a platinum preparation that were published in the 1990s remain standard therapy for untreated non-small-cell lung cancer today. Cisplatin or carboplatin is used as the platinum preparation, but combination therapy with cisplatin has been found to have a greater antitumor effect than combination therapy with carboplatin. However, there is very little difference between them, and on balance, when adverse reactions, etc. are taken into consideration, we do not think that it makes much difference which one of them is used. Clinical studies of combinations between platinum preparations and pemetrexed and S-1, which have been developed since 2000, have been conducted recently. Docetaxel has been established as standard therapy for recurrent cases, but based on the results of recent comparative studies, a survival-prolonging effect has been shown for pemetrexed and for EGFR tyrosine kinase inhibitors (gefitinib, erlotinib), which are molecularly targeted drugs, and it has now become possible to select treatment methods by choosing from a number of anticancer drugs. EGFR tyrosine kinase inhibitors have been demonstrated to have a very high cytoreductive effect on lung cancers that have EGFR gene mutations. The frequency of EGFR gene mutations is high in East Asia, including Japan, whereas it is very low in Western countries. Thus, the future course of development of chemotherapy for non-small-cell lung cancer may differ in Western countries and Asia, and the method of using EGFR tyrosine kinase inhibitors is expected to have great implications in Asia.

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