Advanced Lung Cancer--Reaching a Survival Ceiling with Chemotherapy, The Nibs, And the Mabs (Clinical Report‪)‬

1. Introduction Lung cancer is the leading cause of cancer-related deaths in the United States and worldwide [1,2]. Intensive research and many clinical trials have yielded little improvement in overall survival (OS), according to the American Cancer Society [3]. A recent study using the SEER database demonstrated that, between the years 1990 and 2005, one-year OS increased from 13.2 to 19.4%, and two-year OS only increased from 4.5 to 7.8% [4]. For non-small cell lung cancer, the most prevalent type, the one-year survival rate for all stages combined has remained unchanged for many years at approximately 15% [2,5]. The 5-year survival for patients diagnosed with stage IV disease is only 1% [6]. Chemotherapy and radiation continue to be the mainstays of treatment for patients with advanced disease, and targeted agents (biologics) seem to have added little improvement to OS while dramatically increasing costs and producing significant clinical side effects.