Primary treatment of non-small cell lung cancer

Lung cancer is the cancer entity with the highest mortality, with NSCLC representing the most frequent histological subtype (70-80%). Depending on tumor and metastasis stage, standard therapeutic modalities are substantially different. For high quality cancer care, the various therapeutic options for a patient should be discussed in interdisciplinary teams that include oncologists, pulmologists, radiotherapists, and thoracic surgeons. At initial presentation, 55% of patients are already in a metastasized stage. More than 50% of the patients, who do not show metastasis initially, develop metachrone metastasis during the further course of the disease. For these patients, palliative polychemotherapy as the standard of care can lead to increased overall survival and to improved quality of life. Recently, molecular targeted therapy has been shown to be very effective in selected patients. This article summarizes the therapeutic options in first line therapy depending on tumor stage. Despite all efforts, a relevant decrease in mortality from optimized therapy has not been achieved so far. Therefore, prevention of lung cancer has still first priority.