Management of Metastatic Non-Small-Cell Lung Cancer and a Consideration of Cost

¹ Professor of Medicine and Chairman.

The treatment of selected patients with metastatic NSCLC is supported by the high frequency of response of disease-related symptoms and a modest survival advantage over BSC as evidenced by an increase in median survival time, an approximate doubling of the proportion of patients alive at 1 year, and the small number of patients alive at 2 years. In addition, improved antiemetic therapy has reduced the incidence of chemotherapy-related gastrointestinal toxicity, lessening adverse side effects as a reason to exclude appropriate patients from a therapy trial. Finally, the concern that chemotherapy for advanced NSCLC is an exorbitant cost to the health care system is partially assuaged by the observation that chemotherapy can be less expensive than BSC, and the fact that the costs of managing patients with advanced disease are similar to those of other commonly accepted health care practices.