A critical look at the role of chemotherapy in older patients with non-small cell lung cancer

Lung cancer remains the leading cause of cancer-related death in the United States, and, at the same time, the American population is getting older. These two factors have given rise to a greater focus on how best to treat non-small cell lung cancer in older patients with cancer. Recent studies have defined the benefits of chemotherapy in older patients with metastatic cancer, and the use of single agent therapy is well justified. In this review, we focus on the need to initiate clinical trials that are specifically designed for older patients with cancer, the role ongoing efforts to identify prognostic factors, the importance of studying newer agents up front in older patients, and the value of phase III trials in this patient population.