ORE PERSONS IN THE United States die from non-small cell lung cancer (NSCLC) than from breast, colorectal, and prostate cancer combined. 1 Each year, more than 60000 persons develop stages IIIB and IV NSCLC; nearly all go on to die from metastatic spread. In addition, most individuals experience symptoms caused directly by lung cancer. These symptoms are often the first manifestations of the illness and increase in frequency and severity as the disease progresses. Cough, shortness of breath, weight loss, loss of appetite, and chest tightness impair the quality of lives already cut short by NSCLC. For patients with advanced lung cancer, physical well-being and changes in quality of life correlate with survival. 2 Espe-Author Affiliations and Financial Disclosures are listed at the end of this article.

Erlotinib with concurrent carboplatin and paclitaxel did not confer a survival advantage over carboplatin and paclitaxel alone in patients with previously untreated advanced NSCLC. Never smokers treated with erlotinib and chemotherapy seemed to experience an improvement in survival and will undergo further investigation in future randomized trials.