The use of chemotherapy after curative resection is standard in many common malignancies such as breast and colon cancer and is commonly described as adjuvant therapy. The magnitude of benefit with respect to improvement in disease-free and overall survival in many cases is often small in absolute terms especially in the case of breast cancer where absolute potential improvements may only be in the range of 5% at 10 years. Lung cancer is the most lethal of the common malignancies with non-small cell lung cancer (NSCLC) comprising approximately 80% of cases. Unfortunately, only a minority of patients present with resectable disease, and despite this, the median survival with curative intent surgery is relatively poor (pathological stage I disease 67% at 5 years, pathological stage 2b disease 39% at 5 years). NSCLC is predominantly a disease of the elderly with median age at diagnosis of 68 years, and its management is often complicated by the relatively high rate of concomitant illnesses. Continue reading →