Individualized Adjuvant Chemotherapy for Surgically Resected Lung Cancer and the Roles of Biomarkers

Several prospective randomized trials for patients with completely resected stages II and IIIA nonsmall cell lung cancer have confirmed a survival benefit with cisplatin-based adjuvant chemotherapy. The Lung Adjuvant Cisplatin Evaluation, which is based on pooled analyses of five randomized trials, has demonstrated a 4.2% absolute survival benefit at 5 years. The stage is the benchmark standard used to decide the indication for adjuvant chemotherapy; however, it is important to identify and select the patients who would benefit from adjuvant chemotherapy and to choose the optimal regimen for each case. The translational research was performed using specimens obtained in the above adjuvant trials also to obtain information concerning biomarkers and subsets of patients who would benefit from adjuvant chemotherapy. The extent to which individualized treatment of lung cancer can be provided, especially adjuvant chemotherapy, is discussed in this manuscript. (Ann Thorac Cardiovasc Surg 2009; 15: 144-149)