Rafal Dziadziuszko, MD, PhD

Almost 40% of patients with newly diagnosed small-cell lung cancer (SCLC) have disease confined to the ipsilateral hemithorax and within a single radiation port, ie, limited-stage disease. The median survival for this group of patients after treatment is approximately 15 months, with one in every four patients surviving 2 years. Current optimal treatment consists of chemotherapy with platinum/etoposide, given concurrently with thoracic radiation. Surgery may represent an option for very early-stage disease, but its added value is uncertain. Prophylactic cranial irradiation (PCI) is used for patients with limited-stage SCLC who have achieved a complete response following initial therapy, as it decreases the risk of brain metastases and provides an overall survival benefit. Newer targeted agents are currently being evaluated in this disease and hold the promise of improving current outcomes seen in patients with early-stage disease.

Inhibitors targeting the family ofepidermal growth factor receptors(EGFRs) are novel antitumor compoundsinvestigated in many cancertypes, including non–small-cell lungcancer (NSCLC). In this special lungcancer issue of ONCOLOGY, Drs.Buter and Giaccone provide us withan updated review of clinical researchon two classes of these agents inNSCLC: small-molecule tyrosinekinase inhibitors (TKIs) and monoclonalantibodies. The former classincludes gefitinib (Iressa) and erlotinib(Tarceva), two orally availablequinazoline derivatives targeting thetyrosine kinase domain of EGFR. Thelatter includes cetuximab (Erbitux), achimeric monoclonal antibody directedagainst EGFR. The authors extensivelydiscuss single-agent andcombination activities of these drugsin NSCLC.