CBCE - The Center for Biomedical Continuing Education

Cancer of the lung and bronchus is the leading cause of cancer death in the United States for both men and women. Survival rates are low, even in early-stage disease, with 5-year survival rates of 70% and 50% for stage I and II disease, respectively. Even after resection, most patients will experience a recurrence at a distant site, and 30%-60% of resected patients will die of their disease. Thus, adjuvant therapy has been investigated as a means to eradicate micrometastases and increase survival. Trials have shown that platinum-based adjuvant chemotherapy confers a 4%-15% survival advantage in patients with stage II-IIIA non–small cell lung cancer (NSCLC). In an effort to improve efficacy of adjuvant chemotherapy, 2 strategies are currently being explored. First, predictive biomarkers and molecular models are being developed that may aid in stratifying patients according to how responsive their tumors may be to specific chemotherapeutic agents. Retrospective studies have shown that using molecular markers, such as RRM1 and ERCC1, or genomic approaches, such as the lung metagene model, is feasible and potentially beneficial. In addition, with the success of targeted agents in prolonging survival in advanced or metastatic NSCLC, these agents are now being investigated for benefit in adjuvant therapy. Trials are ongoing to determine whether targeted adjuvant therapy may provide additional benefit to patients with early-stage NSCLC. At the end of this program, participants will be able to describe how tumor molecular characteristics may impact patient outcome or therapeutic response, discuss recent clinical data investigating the use of tumor biomarkers in directing therapy, and explain important considerations affecting how targeted agents might be used in the adjuvant setting.