New Treatment Strategies in Patients with Advanced Non–Small-Cell Lung Cancer and Performance Status 2

Patients with performance status (PS) 2 represent approximately 30%–40% of all patients with advanced non–small-cell lung cancer (NSCLC) seen in clinical practice. Although these patients have been historically excluded from randomized clinical trials, recent studies have suggested a benefit from systemic chemotherapy. The development of biologic agents offers a new promise for the treatment of PS 2 patients as a result of the perceived improved therapeutic index of these agents. However, many of the recent advances in NSCLC have been limited to good PS patients and have not translated into an improvement in the management of the PS 2 population because the studies have excluded this patient population or have failed to demonstrate a survival benefit.