In an effort to further our understanding of lung cancer biology and to identify new candidate biomarkers to be used in the management of lung cancer, we need to probe these tissues and biological fluids with tools that address the biology of lung cancer directly at the protein level. Proteins are responsible of the function and phenotype of cells. Cancer cells express proteins that distinguish them from normal cells. Proteomics is defined as the study of the proteome, the complete set of proteins produced by a species, using the technologies of large-scale protein separation and identification. As a result, new technologies are being developed to allow the rapid and systematic analysis of thousands of proteins. The analytical advantages of mass spectrometry (MS), including sensitivity and highthroughput, promise to make it a mainstay of novel biomarker discovery to differentiate cancer from normal cells and to predict individuals likely to develop or recur with lung cancer. In this review, we summarize the progress made in clinical proteomics as it applies to the management of lung cancer. We will focus our discussion on how MS approaches may advance the areas of early detection, response to therapy, and prognostic evaluation.Keywords: proteome; translational research; biomarkers Lung cancer is the leading cause of cancer-related death worldwide among both males and females, with more than 1 million deaths annually (1). Non-small cell lung cancer (NSCLC) accounts for about 80% of all lung cancers. Although advances have been made in diagnosis and treatment strategies in the last decade, the prognosis of NSCLC patients is poor, with a 5-year overall survival of 15 to 20% (2). This is mainly due to a lack of early diagnosis tools, with more than 60% of the patients diagnosed with advanced or metastatic disease (3) and therefore not eligible for a curative surgical resection. Lung cancer is often suspected on the basis of abnormal chest imaging and/or nonspecific symptoms. Bronchoscopy, with cytopathologic examination of bronchoalveolar lavage, endobronchial brushings and biopsies obtained from the suspect area, is in general used as an initial diagnostic tool. However, while this procedure is 100% specific for lung cancer, the sensitivity is low and ranges from 30% for small peripheral lesions to 80% for central endobronchial tumors (4). More invasive and expensive diagnostic tests are often required, delaying the diagnosis and the subsequent treatment initiation. Surgical resection offers the best chance for cure. For patients undergoing surgery, the longterm prognosis remains disappointing, with a 5-year overall survival of 50% only (5). Recent studies showed that survival of surgically resected patients with NSCLC might be improved by systemic platinum-based adjuvant chemotherapy (6, 7), but which patients might benefit from this treatment cannot be determined accurately.To improve lung cancer management and survival, there is a great need to develop screening and early diagnosis strategies that are sensitive,...